Nuevas aplicaciones de la cápsula endoscópica: PILLCAM™ ESO

ABSTRACT Capsule endoscopy has opened a new era in small bowel examination. Its indications are now welldefined and currently, wireless capsule endoscopy is considered as the first-line imaging tool for the diagnosis of small bowel diseases. ECE has been shown to be feasible, safe and a good alternative technique in patients refusing conventional endoscopy. Although results reported in both GERD and cirrhotic patients are encouraging, great differences in terms of accuracy (particularly in GERD patients) have been found in published studies. These differences have been attributed to study designs, the lack of adequate experience and inconvenience of ingestion protocols. In summary, more large-scale studies evaluating the new 14-fps capsule, adequate ECE-experience and new modified ingestion protocols are still needed

LiNi0.5Mn1.5O4 Thin Films Grown by Magnetron Sputtering under Inert Gas Flow Mixtures as High-Voltage Cathode Materials for Lithium-Ion Batteries

Delivering a commercial high-voltage spinel LiNi0.5Mn1.5O4 (LNMO) cathode electrode for Li-ion batteries would result in a significant step forward in terms of energy density. However, the structural ordering of the spinel and particle size have considerable effects on the cathode material's cyclability and rate capability, which are crucial challenges to address. Here, a novel mid-frequency alternating current dual magnetron sputtering method was presented, using different Ar-N-2 gas mixtures ratios for the process gas to prepare various LNMO thin films with highly controlled morphology and particle size; as determined from X-ray diffraction, Raman spectroscopy and electron microscopy. It resulted in enhanced cycling and rate performance. This processing method delivered N-containing LNMO thin film electrodes with up to 15 % increased discharge capacity at 1 C (120 mAh g(-1)) with respect to standard LNMO (grown under only Ar gas flow) thin film electrodes, along with outstanding rate performance up to 10 C (99 mAh g(-1)) in the operating voltage window 3.5-4.85 V vs. Li+/Li. Besides, electrochemical impedance spectroscopy results showed that the intricate phase transitions present in standard LNMO electrodes were almost suppressed in N-containing LNMO thin films grown under different Ar-N-2 gas flow mixtures

Capsule endoscopy interpretation: the role of physician extenders

Background and aims: capsule endoscopy (CE) allows for a new era in small-bowel examination. Nevertheless, physicians’ time for CE-interpretation remains longer than desirable. Alternative strategies to physicians have not been widely investigated. The aim of this study was to evaluate the accuracy of physician extenders in CE-interpretation. Material and methods: one CE-experienced gastroenterologist and two physician extenders reviewed independently 20 CEprocedures. Each reader was blinded to the findings of their colleagues. A consensus formed by the readers and a second CE-experienced gastroenterologist was used as gold standard. Number, type and location of images selected, character of CEexams and their relationship with indications were recorded. Gastric emptying time (GEt), small-bowel transit time (SBTt) and time spent by readers were also noted. Results: sensitivity and specificity for “overall” lesions was 79 and 99% for the gastroenterologist; 86 and 43% for the nurse; and 80 and 57% for the resident. All 34 “major” lesions considered by consensus were found by the readers. Agreement between consensus and readers for images classification and procedures interpretation was good to excellent (κ from 0.55 to 1). No significant differences were found in the GEt and SBTt obtained by consensus and readers. The gastroenterologist was faster than physician extenders (mean time spent was 51.9 ± 13.5 minutes versus 62.2 ± 19 and 60.9 ± 17.1 for nurse and resident, respectively; p < 0.05). Conclusions: physician extenders could be the perfect complement to gastroenterologists for CE-interpretation but gastroenterologists should supervise their findings. Future cost-efficacy analyses are required to assess the benefits of this alternative

Mesenchymal stem cell therapy in retinal and optic nerve diseases: An update of clinical trials

Producción CientíficaRetinal and optic nerve diseases are degenerative ocular pathologies which lead to irreversible visual loss. Since the advanced therapies availability, cell-based therapies offer a new all-encompassing approach. Advances in the knowledge of neuroprotection, immunomodulation and regenerative properties of mesenchymal stem cells (MSCs) have been obtained by several preclinical studies of various neurodegenerative diseases. It has provided the opportunity to perform the translation of this knowledge to prospective treatment approaches for clinical practice. Since 2008, several first steps projecting new treatment approaches, have been taken regarding the use of cell therapy in patients with neurodegenerative pathologies of optic nerve and retina. Most of the clinical trials using MSCs are in Ⅰ/Ⅱ phase, recruiting patients or ongoing, and they have as main objective the safety assessment of MSCs using various routes of administration. However, it is important to recognize that, there is still a long way to go to reach clinical trials phase Ⅲ-Ⅳ. Hence, it is necessary to continue preclinical and clinical studies to improve this new therapeutic tool. This paper reviews the latest progress of MSCs in human clinical trials for retinal and optic nerve diseasesJunta de Castilla y León (programa de apoyo a proyectos de investigación – Ref. VA066U13

Induction of TIMP-1 expression in rat hepatic stellate cells and hepatocytes: a new role for homocysteine in liver fibrosis

Elevated plasma levels of homocysteine have been shown to interfere with normal cell function in a variety of tissues and organs, such as the vascular wall and the liver. However, the molecular mechanisms behind homocysteine effects are not completely understood. In order to better characterize the cellular effects of homocysteine, we have searched for changes in gene expression induced by this amino acid. Our results show that homocysteine is able to induce the expression and synthesis of the tissue inhibitor of metalloproteinases-1 (TIMP-1) in a variety of cell types ranging from vascular smooth muscle cells to hepatocytes, HepG2 cells and hepatic stellate cells. In this latter cell type, homocysteine also stimulated alpha 1(I) procollagen mRNA expression. TIMP-1 induction by homocysteine appears to be mediated by its thiol group. Additionally, we demonstrate that homocysteine is able to promote activating protein-1 (AP-1) binding activity, which has been shown to be critical for TIMP-1 induction. Our findings suggest that homocysteine may alter extracellular matrix homeostasis on diverse tissular backgrounds besides the vascular wall. The liver could be considered as another target for such action of homocysteine. Consequently, the elevated plasma levels of this amino acid found in different pathological or nutritional circumstances may cooperate with other agents, such as ethanol, in the onset of liver fibrosis

Drivers of variation in seagrass-associated amphipods across biogeographical areas

Amphipods are one of the dominant epifaunal groups in seagrass meadows. However, our understanding of the biogeographical patterns in the distribution of these small crustaceans is limited. In this study, we investigated such patterns and the potential drivers in twelve Cymodocea nodosa meadows within four distinctive biogeographical areas across 2000 Km and 13° of latitude in two ocean basins (Mediterranean Sea and Atlantic Ocean). We found that species abundances in the assemblage of seagrass-associated amphipods differed among areas following a pattern largely explained by seagrass leaf area and epiphyte biomass, while the variation pattern in species presence/absence was determined by seagrass density and epiphyte biomass. Seagrass leaf area was also the most important determinant of greater amphipod total density and species richness, while amphipod density also increased with algal cover. Overall, our results evidenced that biogeographical patterns of variation in amphipod assemblages are mainly influenced by components of the habitat structure, which covary with environmental conditions, finding that structurally more complex meadows harboring higher abundance and richness of amphipods associated.This work was supported by the Portuguese Foundation for Science and Technology (FCT) under the contract program DL57/2016/CP1361/CT0004 and CCMAR through the projects UIDB/04326/2020, UIDP/04326/2020 and LA/P/0101/2020

Skin gene therapy for acquired and inherited disorders

The rapid advances associated with the Human Genome Project combined with the development of proteomics technology set the bases to face the challenge of human gene therapy. Different strategies must be evaluated based on the genetic defect to be corrected. Therefore, the re-expression of the normal counterpart should be sufficient to reverse phenotype in single-gene inherited disorders. A growing number of candidate diseases are being evaluated since the ADA deficiency was selected for the first approved human gene therapy trial (Blaese et al., 1995). To cite some of them: sickle cell anemia, hemophilia, inherited immune deficiencies, hyper-cholesterolemia and cystic fibrosis. The approach does not seem to be so straightforward when a polygenic disorder is going to be treated. Many human traits like diabetes, hypertension, inflammatory diseases and cancer, appear to be due to the combined action of several genes and environment. For instance, several wizard gene therapy strategies have recently been proposed for cancer treatment, including the stimulation of the immune system of the patient (Xue et al., 2005), the targeting of particular signalling pathways to selectively kill cancer cells (Westphal and Melchner, 2002) and the modulation of the interactions with the stroma and the vasculature (Liotta, 2001; Liotta and Kohn, 2001).Our work is supported by grants SAF-2004-07717 from Ministerio de Ciencia y Tecnología (Spain) and LSHG-512073 from UE to M. Del Rio, LSHG-503447 from UE to J.L. Jorcano and LSHG-512102 from UE to F. Larcher. We express our gratitude to Dr. Y. Gache, Dr. F. Spirito and Dr. G. Meneguzzi for providing EM pictures to illustrate this work

International core curriculum for capsule endoscopy training courses

Capsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe. The following suggestions in this curriculum are based on the experience of European CE training courses directors. It is suggested that 12 hours be dedicated for either a small bowel capsule endoscopy (SBCE) or a colon capsule endoscopy (CCE) course with 4 hours for an introductory CCE course delivered in conjunction with SBCE courses. SBCE courses should include state-of-the-art lectures on indications, contraindications, complications, patient management and hardware and software use. Procedural issues require approximately 2 hours. For CCE courses 2.5 hours for theoretical lessons and 3.5 hours for procedural issued are considered appropriate. Hands-on training on reading and interpretation of CE cases using a personal computer (PC) for 1 or 2 delegates is recommended for both SBCE and CCE courses. A total of 6 hours hands-on session- time should be allocated. Cases in a SBCE course should cover SB bleeding, inflammatory bowel diseases (IBD), tumors and variants of normal and cases with various types of polyps covered in CCE courses. Standardization of the description of findings and generation of high-quality reports should be essential parts of the training. Courses should be followed by an assessment of trainees' skills in order to certify readers' competency.info:eu-repo/semantics/publishedVersio