Pancreatic Necrosectomy Through a Novel Double-flange Lumen-apposing Covered Metal Stent (Video)

AbstractPancreatic fluid collections (PFCs) represent a complication of acute pancreatitis. Endoscopic management of PFCs is an alternative to surgery [1]. Classic strategies include access to the collection under endoscopic ultrasound (EUS)-guidance and placement of several double-pigtail stents. PFCs containing organized necrosis are classified as walled-off necrosis (WON). In those cases necrosis is hardly evacuated and will require necrosectomy in most cases. Every necrosectomy session needs prior removal of the stents, dilatation of the tract, debridement and placement of new stents adding up a considerable overall cost to the intervention. A novel double-flanged lumen-apposing fully-covered self-expandable metal stent (FC-SEMS) with a 15mm diameter accelerates exit of the necrosis and facilitates multiple necrosectomy sessions.We present a 60 year old patient admitted to the intensive care unit for severe acute pancreatitis that developed WON with superinfection. The intensivists and surgeons indicated endoscopic cystgastrostomy to evacuate the collection. Using the echoendoscope we found a large collection adherent to the gastric wall. The collection was accessed under EUS-guidance using the Hot AXIOS™ catheter that features a cautery tip, then a 15mm AXIOS™ stent was deployed through the cystgastrostomy orifice to keep it patent. The patient required two necrosectomy sessions to clean the cavity. The WON resolved in 6 weeks and the stent was removed unevently. The patient was discharged.A double flange lumen apposing FC-SEMS used as a port for necrosectomy significantly improves management of walled-off pancreatic necrosis. Placement of this stents should be considered when multiple necrosectomy sessions are anticipated. Procedure time can be significantly decreased using a catheter that combines a cautery tip and stent delivery system

Peritoneal dialysis associated-peritonitis: a preventable complication

Peritoneal dialysis is useful renal replacement therapy for patients with end-stage chronic kidney disease. Latin America has 30% of the world population in peritoneal dialysis and within these countries Mexico covers 73% of them. In our country, the Mexican institute of social security (IMSS by its Spanish acronym) serves more than half of the Mexican population that requires renal replacement therapy. In 2014 it represented 15% of total annual cost of the institution. Peritonitis in peritoneal dialysis is the main complication seen in this renal replacement therapy with morbidity and mortality from 2 to 6%. The epidemiology of peritonitis associated with peritoneal dialysis varies according to the continent, country and dialysis center. The rate of peritonitis per year of each center reflects their quality of care. The prevention, diagnosis and treatment of peritonitis impact in the quality of life of the patient, the success of renal replacement therapy, public health costs and associated mortality. This review addresses the epidemiology, diagnosis, treatment, and preventive measures of peritonitis, focused on the procedures for improving the standards of care

Bioinspired design of triboceramics: Learning from the anisotropic microfracture response of dental enamel under sliding contact

[EN] In the quest for novel ceramics for tribological applications via bioinspired design, the differences in the fracture modes that arise upon scratching relevant locations of ceramic-like tooth enamel are investigated. It is found that fracture initiates from weak rod-sheath interfaces at relatively low loads, independent of the sliding direction. However, the geometry and propagation of the cracks depends on the orientation of the interfaces relative to the maximum tensile stress: scratching along the occlusal surface propagates approximately sinusoidal cracks, parallel to the sliding direction, while scratching along the cross-section produces straight cracks that propagate normal (scratch parallel to occlusal surface) or parallel (scratch perpendicular to occlusal surface) to the sliding direction. The formation of cracks is hindered in scratching near the enamel-dentine junction. Implications for the microstructural design of triboceramics (bulks and coatings) with improved durability are discussed.The authors wish to thank Dr Florencio Monje Gil for kindly providing tooth specimens from his clinic (CICOM, Centro de Implantologia Cirugia Oral y Maxilofacial, Badajoz, Spain). This study was supported by Junta de Extremadura, Spain, and FEDER/ERDF funds (grants IB16139 and GR18149), and the Spanish Ministry of Science and Innovation (grant PID2019-105377RB-I00). E. P.-C. gratefully acknowledges support from the Spanish Ministry of Economy and Competitiveness (MINECO) under grant FJCI-2015-27228.Sanchez-Gonzalez, E.; Rodriguez-Rojas, F.; Pinilla-Cienfuegos, E.; Borrero-Lopez, O.; Ortiz, AL.; Guiberteau, F. (2020). Bioinspired design of triboceramics: Learning from the anisotropic microfracture response of dental enamel under sliding contact. Ceramics International. 46(18):27983-27989. https://doi.org/10.1016/j.ceramint.2020.07.2922798327989461

1-(2-Chlorobenzyloxy)-3-[1,2,3]triazol-1-yl-propan-2-ol Derivatives: Synthesis, Characterization, and DFT-Based Descriptors Analysis

A novel series of 1-(2-chlorobenzyloxy)-3-[1,2,3]triazol-1-yl-propan-2-ol derivatives was designed and synthesized using copper catalyzed alkyne-azide cycloaddition in the key step. Theoretical investigation of molecular and electronic properties by means of global and local reactivity indexes of the synthetized compounds was carried out, using DFT (Density Functional Theory) at PBEPBE/6-31++G∗∗ levelCONACY

Experimental Evaluation of a Team of Multiple Unmanned Aerial Vehicles for Cooperative Construction

This article presents a team of multiple Unmanned Aerial Vehicles (UAVs) to perform cooperative missions for autonomous construction. In particular, the UAVs have to build a wall made of bricks that need to be picked and transported from different locations. First, we propose a novel architecture for multi-robot systems operating in outdoor and unstructured environments, where robustness and reliability play a key role. Then, we describe the design of our aerial platforms and grasping mechanisms to pick, transport and place bricks. The system was particularly developed for the Mohamed Bin Zayed International Robotics Challenge (MBZIRC), where Challenge 2 consisted of building a wall cooperatively with multiple UAVs. However, our approach is more general and extensible to other multi-UAV applications involving physical interaction, like package delivery. We present not only our results in the final stage of MBZIRC, but also our simulations and field experiments throughout the previous months to the competition, where we tuned our system and assessed its performance

Altered protein expression and protein nitration pattern during d-galactosamine-induced cell death in human hepatocytes: a proteomic analysis

BACKGROUND/AIMS: Hepatic injury by d-galactosamine (d-GalN) is a suitable experimental model of hepatocellular injury. The induction of oxidative and nitrosative stress participates during d-GalN-induced cell death in cultured rat hepatocytes. This study aimed to identify protein expression changes during the induction of apoptosis and necrosis by d-GalN in cultured human hepatocytes. METHODS: A proteomic approach was used to identify the proteins involved and those altered by tyrosine nitration. A high dose of d-GalN (40 mM) was used to induce apoptosis and necrosis in primary culture of human hepatocytes. Cellular lysates prepared at different times after addition of d-GalN were separated by two-dimensional electrophoresis. Gel spots with an altered expression and those matching nitrotyrosine-immunopositive proteins were excised and analyzed by mass spectrometry. RESULTS: d-GalN treatment upregulated microsomal cytochrome b5, fatty acid binding protein and manganese superoxide dismutase, and enhanced annexin degradation. d-GalN increased tyrosine nitration of four cytosolic (Hsc70, Hsp70, annexin A4 and carbonyl reductase) and three mitochondrial (glycine amidinotransferase, ATP synthase beta chain, and thiosulfate sulfurtransferase) proteins in human hepatocytes. CONCLUSIONS: The results provide evidences that oxidative stress and nitric oxide-derived reactive oxygen intermediates induce specific alterations in protein expression that may be critical for the induction of apoptosis and necrosis by d-GalN in cultured human hepatocytes

Estado del arte del proyecto

The aim of REMIND is to create an International and Intersectoral network to facilitate the exchange of staff to progress developments in reminding technologies for persons with dementia that can be deployed in smart environments. The consortium is comprised of an International network of 7 academic beneficiaries, 5 nonacademic beneficiaries and 4 partners from Third Countries, all of whom are committed to progressing the notion of reminding technologies within smart environments. The focus of REMIND is to develop staff and beneficiary/partner skills in the areas of user centered design and behavioral science coupled with improved computational techniques which in turn will offer more appropriate and efficacious reminding solutions. This will be further supported through research involving user centric studies into the use of reminding technologies and the theory of behaviour change to improve compliance of usage. Research objectives will be focused within the domain of smart environments. A smart environment can be viewed as having the ability to sense its surroundings through embedded sensors and following processing of the sensed information, adjust the environment through actuators to offer an improved experience for the inhabitant. Even though the availability, cost, size and battery life of sensing technology have all improved in recent years, the uptake of real smart environments has been limited. This is mainly related to the effort required to support the technical deployments and the lack of a business model to support a service provider capable of offering support to a large number of environments. In addition, there is a limit to the amount of scenarios which can be facilitated by such environments; this limit is directly related to the number of sensors availabl