Endoscopic approach to benign biliary obstruction

AbstractDuring the past 30 years, the endoscopic approach to benign biliary strictures (BBS) became the preferred “mini-invasive” treatment modality for benign diseases. Endoscopic plastic or metallic stenting, and balloon dilation represent the gold standard treatment for BBS. Side-by-side insertion of multiple plastic stents is a very effective treatment option for BBS following cholecystectomy or liver transplantation. This strategy has a low recurrence rate on long-term follow-up, with better results than fully covered self-expandable metal stents (FC-SEMS). FC-SEMS seems to have an advantage and higher stricture resolution rate in patients with BBS secondary to chronic pancreatitis. Dilation of dominant biliary strictures in patients with primary sclerosing cholangitis has a lower rate of infective complications than the stenting treatment. Endoscopic retrograde cholangiopancreatography represents a safe and effective approach to BBS, with a very high success rate, especially when such cases are managed in a multidisciplinary setting

p130Cas/ BCAR1 and p140Cap/ SRCIN1 Adaptors: The Yin Yang in Breast Cancer?

p130Cas/BCAR1 is an adaptor protein devoid of any enzymatic or transcriptional activity, whose modular structure with various binding motifs, allows the formation of multi-protein signaling complexes. This results in the induction and/or maintenance of signaling pathways with pleiotropic effects on cell motility, cell adhesion, cytoskeleton remodeling, invasion, survival, and proliferation. Deregulation of p130Cas/BCAR1 adaptor protein has been extensively demonstrated in a variety of human cancers in which overexpression of p130Cas/BCAR1 correlates with increased malignancy. p140Cap (p130Cas associated protein), encoded by the SRCIN1 gene, has been discovered by affinity chromatography and mass spectrometry analysis of putative interactors of p130Cas. It came out that p140Cap associates with p130Cas not directly but through its interaction with the Src Kinase. p140Cap is highly expressed in neurons and to a lesser extent in epithelial tissues such as the mammary gland. Strikingly, in vivo and in vitro analysis identified its tumor suppressive role in breast cancer and in neuroblastoma, showing an inverse correlation between p140Cap expression in tumors and tumor progression. In this review, a synopsis of 15 years of research on the role of p130Cas/BCAR1 and p140Cap/SRCIN1 in breast cancer will be presented

Dynamics of SARS-CoV-2 in wastewater in three districts of the Buenos Aires metropolitan region, Argentina, throughout nine months of surveillance: A pilot study

In the current pandemic of COVID-19, sewage surveillance of SARS-CoV-2 genome has been used to complement viral epidemiology in different countries. The aim of this work was to introduce and evaluate this wastewaterbased tool in the metropolitan region of Buenos Aires, Argentina. As a pilot study, surveillance of SARS-CoV-2 in wastewater from three districts of this area was performed for more than nine months from June 2020 to April 2021. Viruses present in the samples were concentrated using polyethylene glycol precipitation and quantified using RT-qPCR CDC N1 assay. Virus recovery for SARS-CoV-2 and a potential surrogate, bovine coronavirus Mebus strain, that shares the Betacoronavirus genus and structural characteristics with SARS-CoV-2, were evaluated after concentration and detection procedures. Recovery of both viruses did not differ significantly, with a median for SARS-CoV-2 and BCoV of 0.085 (95% CI: 0.021-0.179) and 0.262 (95% CI: 1.18 × 10-5-0.564) respectively. The concentration of SARS-CoV-2 genome in wastewater ranged from 10 -1 to 10 3 cg/ml, depending on the wastewater treatment plant, type of collection site, viral recovery of the concentration method and the epidemiological situation of the outbreaks. Significant correlations were observed between SARS-CoV-2 concentration in wastewater and reported clinical cases, reinforcing the utility of this approach to monitor the epidemiological status of populations.Fil: Barrios, Melina Elizabeth. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Díaz, Sofía Micaela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Ministerio de Ciencia. Tecnología e Innovación Productiva. Agencia Nacional de Promoción Científica y Tecnológica; ArgentinaFil: Torres, Carolina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Costamagna, Damián Matías. Autoridad del Agua. - Gobierno de la Provincia de Buenos Aires. Ministerio de Infraestructura y Servicos Publicos. Autoridad del Agua.; ArgentinaFil: Blanco Fernandez, Maria Dolores. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mbayed, Viviana Andrea. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Forzantes ambientales intervinientes en la dinámica trófica de la Laguna del Plata (Córdoba)

El análisis de indicadores paleolimnológicos físicos, químicos y biológicos del registro sedimentario de Laguna del Plata (LdP), sistema de la Laguna Mar Chiquita (LMC) (Córdoba, Argentina), permitió reconstruir la variabilidad ambiental ocurrida en los últimos ca. 70 años y relacionarla con la variabilidad hidroclimática del sistema y con el impacto de las actividades antrópicas en la región. Se identificaron 4 escenarios con características ambientales diferentes. El incremento en las concentraciones de nutrientes determinado a partir del año 1984 en el registro sedimentario es sincrónico con el avance de la frontera agrícola en la región, la cual se expandió en la década de 1980. Además, los resultados muestran el control que ejerce la variabilidad hidroclimática sobre el ingreso de nutrientes a LdP permitiendo relacionar forzantes antrópicos y naturales. Asimismo, se observó que, durante períodos de alto impacto antrópico, la mayor disponibilidad de nutrientes es el factor que predomina en el control de la producción primaria de LdP.Este trabajo considera la acción simultánea de forzantes naturales y antrópicos, y aporta al entendimiento de la dinámica ambiental del sistema para los siglos XX y XXI. Por lo anterior, se considera que puede contribuir a la proyección y planeamiento de las actividades de la región.The study of paleolimnological proxies from the sedimentary record of Laguna del Plata (LdP), Lake Mar Chiquita System (LMC) (Córdoba, Argentina), allowed to reconstruct the environmental variability occurred in the last ca. 70 years and relate it to the hydroclimatic variability and to the agricultural activities impact in the area. Four scenarios with different environmental characteristics were identified. The nutrient concentration increase determined in the sedimentary record since 1984, is synchronous with the advance of the agricultural frontier in the region, which was expanded in the 1980s. Moreover, the results showed the control by the hydroclimatic variability on the nutrients input to LdP which allows to relate anthropic and natural forcing. Additionally, it was observed that during periods of high anthropic impact, primary production at LdP is mainly controlled by the high availability of nutrients.Fil: Costamagna, Ingrid. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; ArgentinaFil: Halac, Silvana Raquel. Secretaria de Ambiente y Desarrollo Sustentable de la Nación. Instituto Nacional del Agua y del Ambiente (Córdoba); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones en Ciencias de la Tierra. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Ruiz, Marcia Andrea. Secretaria de Ambiente y Desarrollo Sustentable de la Nación. Instituto Nacional del Agua y del Ambiente (Córdoba); ArgentinaFil: Piovano, Eduardo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones en Ciencias de la Tierra. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones en Ciencias de la Tierra; Argentin

Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome

BACKGROUND: Mechanical ventilation with a tidal volume (V(T)) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (P(plat)) lower than 30 cmH(2)O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low V(T) combined with extracorporeal carbon dioxide removal (ECCO(2)R). METHODS: In fifteen patients with moderate ARDS, V(T) was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure – (P(plat)) between 23 and 25 cmH(2)O. Low-flow ECCO(2)R was initiated when respiratory acidosis developed (pH < 7.25, PaCO(2) > 60 mmHg). Ventilation parameters (V(T), respiratory rate, PEEP), respiratory compliance (C(RS)), driving pressure (DeltaP = V(T)/C(RS)), arterial blood gases, and ECCO(2)R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO(2)R when PaO(2)/FiO(2) was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO(2)R were also collected. RESULTS: During the 2 h run in phase, V(T) reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH < 7.25) in all fifteen patients. At steady state, ECCO(2)R with an average blood flow of 435 mL/min and sweep gas flow of 10 L/min was effective at correcting pH and PaCO(2) to within 10 % of baseline values. PEEP values tended to increase at V(T) of 4 mL/kg from 12.2 to 14.5 cmH(2)O, but this change was not statistically significant. Driving pressure was significantly reduced during the first two days compared to baseline (from 13.9 to 11.6 cmH(2)O; p < 0.05) and there were no significant differences in the values of respiratory system compliance. Rescue therapies for life threatening hypoxemia such as prone position and ECMO were necessary in four and two patients, respectively. Only two study-related adverse events were observed (intravascular hemolysis and femoral catheter kinking). CONCLUSIONS: The low-flow ECCO(2)R system safely facilitates a low volume, low pressure ultra-protective mechanical ventilation strategy in patients with moderate ARDS