Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Adjustable Gastric Banding for the Treatment Severe Obesity in High Risk Patients

Laparoscopic sleeve gastrectomy was found to improve short-term total weight loss; however, it was associated with prolonged operative time, blood loss, and hospital stay compared with laparoscopic adjustable gastric banding

Gastric bypass and banding equally improve insulin sensitivity and β cell function

Bariatric surgery in obese patients is a highly effective method of preventing or resolving type 2 diabetes mellitus (T2DM); however, the remission rate is not the same among different surgical procedures. We compared the effects of 20% weight loss induced by laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery on the metabolic response to a mixed meal, insulin sensitivity, and \u3b2 cell function in nondiabetic obese adults. The metabolic response to meal ingestion was markedly different after RYGB than after LAGB surgery, manifested by rapid delivery of ingested glucose into the systemic circulation, by an increase in the dynamic insulin secretion rate, and by large, early postprandial increases in plasma glucose, insulin, and glucagon-like peptide-1 concentrations in the RYGB group. However, the improvement in oral glucose tolerance, insulin sensitivity, and overall \u3b2 cell function after weight loss were not different between surgical groups. Additionally, both surgical procedures resulted in a similar decrease in adipose tissue markers of inflammation. We conclude that marked weight loss itself is primarily responsible for the therapeutic effects of RYGB and LAGB on insulin sensitivity, \u3b2 cell function, and oral glucose tolerance in nondiabetic obese adults

Assessing Pandemic Preparedness, Response, and Lessons Learned From the Covid-19 Pandemic in Four South American Countries: Agenda for the Future

INTRODUCTION: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world\u27s hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths. METHODS: This study explores how pandemic PPR were affected by political, socioeconomic, and health system contexts as well as how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru. We then identify lessons learned and advance an agenda for improving PPR capacity at regional and national levels. We do this through a mixed-methods sequential explanatory study in four South American countries based on structured interviews and focus groups with elite policy makers. RESULTS: The results of our study demonstrate that structural and contextual barriers limited PPR activities at political, social, and economic levels in each country, as well as through the structure of the health care system. Respondents believe that top-level government officials had insufficient political will for prioritizing pandemic PPR and post-COVID-19 recovery programs within their countries\u27 health agendas. DISCUSSION: We recommend a regional COVID-19 task force, post-pandemic recovery, social and economic protection for vulnerable groups, improved primary health care and surveillance systems, risk communication strategies, and community engagement to place pandemic PPR on Argentina, Brazil, Colombia, and Peru and other South American countries\u27 national public health agendas

Evaluación clínica preliminar del efecto antiparasitario de Stevia rebaudiana Bertoni (ka`a he ê) en adultos y niños

La parasitosis gastrointestinal es una enfermedad que se da preferentemente en la niñez y enadultos inmunocomprometidos. Los tratamientos actuales son, en general, eficaces, pero lacreciente resistencia a los antiparasitarios obliga a la búsqueda de nuevas drogas con urgencia.Este estudio tiene el propósito de evaluar preliminarmente la efectividad de Stevia rebaudianaBertoni como antiparasitário. Se realizó un ensayo clínico aleatorizado a ciego simple, con 22adultos y 134 niños (6-18 años), todos parasitados con helmintos y/o protozoarios. Lostratamientos asignados al azar consistieron en comprimidos de S. rebaudiana (SRB) omebendazol-tinidazol (MBZ-TNZ), ambos en preparaciones farmacéuticas comerciales. En losadultos SRB y MBZ-TNZ redujeron en forma similar la infección por protozoarios y helmintos, y elnúmero de eventos adversos informados para el tratamiento convencional fue mayor que para SRB(p<0,02). Atendiendo a esos resultados se amplió la evaluación a 134 niños portadores deparásitos intestinales, de los que 113 (99,3%) presentaron protozoarios y 28 (20,8%) helmintos,mayoritariamente en co infección. S. rebaudiana redujo significativamente (p<0,001) la frecuenciade global de infección por protozoarios (74,5%) en los niños frente a lo obtenido con MBZ-TNZ(40,7%), destacando la negativización de Giardia lamblia.que resultó el doble con SRB de loobservado con MBZ-TNZ (p<0,001). SRB redujo la frecuencia de helmintos en 70,6% de manerasimilar a MBZ-TNZ (p>0,05). No se registraron efectos adversos asociados a los tratamientos a losniños/as. Los resultados animan a proseguir la evaluación de SRB como potencial agenteantiparasitario

Funcionament dels esfigmomanòmetres en l'assistència primària

Es revisa el funcionament de 102 esfigmomanòmetres localitzats en diferents zones d'assistència primària de Barcelona i comarques circumdants. 44 dels aparells eren de mercuri i 58 aneroides. Un 13,63% dels esfigmomanòmetres de mercuri i un 67,24% dels aparells aneroides funcionaven incorrectament considerant funcionament incorrecte un error igual o superior a 4 mm Hg en la lectura respecte un esfigmomanòmetre control, per excés o per defecte. Únicament en una petita fracció dels aparells l'error es podia justificar pel mal estat de les gomes

HIV/STI co-infection among men who have sex with men in Spain

In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.This work was funded by two grants (36646/07; 36794/08) from the Foundation for Research and Prevention of AIDS in Spain (Fundación para la Investigación y la Prevención del SIDA en España–FIPSE).S

MacroH2A1.1 regulates mitochondrial respiration by limiting nuclear NAD+ consumption

Histone variants are structural components of eukaryotic chromatin that can replace replication-coupled histones in the nucleosome. The histone variant macroH2A.1.1 contains a macrodomain able to bind NAD+ derived metabolites. Here, we report that macroH2A.1.1 is rapidly induced during myogenic differentiation through a switch in alternative splicing. Importantly, myotubes lacking macroH2A.1.1 display a defect in mitochondrial respiratory capacity. We find that the metabolite-interacting macrodomain is essential for sustaining optimal mitochondrial function, but dispensable for gene regulation. Through direct binding, macroH2A.1.1 inhibits basal poly-ADP ribose polymerase 1 activity and thus reduces nuclear NAD+ consumption. Consequentially, accumulation of the NAD+ precursor NMN allows the maintenance of mitochondrial NAD+ pools critical for respiration. Our data indicate that macroH2A.1.1-containing chromatin regulates mitochondrial respiration by limiting nuclear NAD+ consumption and establishing a buffer of NAD+ precursors in differentiated cells

The Rise and Fall of "Respectable" Spanish Liberalism, 1808-1923: An Explanatory Framework

The article focuses on the reasons behind both the consolidation of what I have termed “respectable” liberalism between the 1830s and the 1840s and its subsequent decline and fall between 1900 and 1923. In understanding both processes I study the links established between “respectable” liberals and propertied elites, the monarchy, and the Church. In the first phase these links served to consolidate the liberal polity. However, they also meant that many tenets of liberal ideology were compromised. Free elections were undermined by the operation of caciquismo, monarchs established a powerful position, and despite the Church hierarchy working with liberalism, the doctrine espoused by much of the Church was still shaped by the Counter-Reformation. Hence, “respectable” liberalism failed to achieve a popular social base. And the liberal order was increasingly denigrated as part of the corrupt “oligarchy” that ruled Spain. Worse still, between 1916 and 1923 the Church, monarch, and the propertied elite increasingly abandoned the liberal Monarchist Restoration. Hence when General Primo de Rivera launched his coup the rug was pulled from under the liberals’ feet and there was no one to cushion the fall

J-PLUS: Tools to identify compact planetary nebulae in the Javalambre and southern photometric local universe surveys

From the approximately $\sim$3,500 planetary nebulae (PNe) discovered in our Galaxy, only 14 are known to be members of the Galactic halo. Nevertheless, a systematic search for halo PNe has never been performed. In this study, we present new photometric diagnostic tools to identify compact PNe in the Galactic halo by making use of the novel 12-filter system projects, J-PLUS (Javalambre Photometric Local Universe Survey) and S-PLUS (Southern-Photometric Local Universe Survey). We reconstructed the IPHAS (Isaac Newton Telescope (INT) Photometric H${\alpha}$ Survey of the Northern Galactic Plane) diagnostic diagram and propose four new ones using i) the J-PLUS and S-PLUS synthetic photometry for a grid of photo-ionisation models of halo PNe, ii) several observed halo PNe, as well as iii) a number of other emission-line objects that resemble PNe. All colour-colour diagnostic diagrams are validated using two known halo PNe observed by J-PLUS during the scientific verification phase and the first data release (DR1) of S-PLUS and the DR1 of J-PLUS. By applying our criteria to the DR1s ($\sim$1,190 deg$^2$), we identified one PN candidate. However, optical follow-up spectroscopy proved it to be a H II region belonging to the UGC 5272 galaxy. Here, we also discuss the PN and two H II galaxies recovered by these selection criteria. Finally, the cross-matching with the most updated PNe catalogue (HASH) helped us to highlight the potential of these surveys, since we recover all the known PNe in the observed area. The tools here proposed to identify PNe and separate them from their emission-line contaminants proved to be very efficient thanks to the combination of many colours, even when applied -like in the present work- to an automatic photometric search that is limited to compact PNe