Bioenterics Intragastric Balloon (BIB®): efficacy in treatment of obesity: our experience

INTRODUZIONE L’obesità è una malattia cronica molto diffusa nei paesi occidentali e dovuta ad un eccessivo deposito di grasso corporeo con significative implicazioni mediche, quali diabete di tipo 2, ipertensione, osteo-artriti e psicologiche. Il palloncino intragastrico (Bioenterics Intragastric Balloon) è un sistema utilizzato per la riduzione del oeso corporeo in pz. obesi con comorbidità, in associazione ad una dieta ipocalorica. SCOPO DELLO STUDIO Valutare la tollerabilità e l’efficacia del BIB in soggetti obesi in termini di riduzione del peso corporeo. PAZIENTI E METODI I pz. Sono stati valutati da un team multidisciplinare composto da un internista, un dietologo, un endoscopista e uno psicologo. Dopo questa selezione iniziale è stato posizionato endoscopicamente il BIB. Dopo il posizionamento i pazienti hanno seguito una dieta ipocalorica di 1000 KCalorie e sono stati visitati una volta al mese per 6 mesi.E’ stata valutata la tollerabilità del BIB e la sua efficacia in termini di perdita di peso e di riduzione del BMI. Per le analisi statistiche si sono utilizzate le medie del test T di Student. La p < 0,05 è stata ritenuta significativa. RISULTATI Nel periodo Novembre 2006 – Dicembre 2007 sono stati selezionati 43 pz. obesi per il posizionamento del BIB (19M / 24F ; età media 44,4 ± 12 anni; BMI medio 43,65 ± 8,67 Kg/m2). Non si sono osservate complicazioni relative alle procedure endoscopiche di inserzione e rimozione del palloncino. Gli effetti collaterali rilevati sono stati vomito entro i primi 3 giorni (88%) e raramente sintomi da reflusso occasionalmente (7%). Dopo 6 mesi il BMI si è ridotto significativamente (p < 0,001) passando da 43,65 ± 8,67 a 37,93 ± 7,87 Kg/m2. CONCLUSIONI I risultati di questi studio mostrano come il posizionamento del BIB negli obesi sia una procedura sicura, ben tollerata ed efficace. In associazione con un’appropriata dieta ipocalorica è significativamente efficace nella riduzione del peso corporeo. Un attento follow up dei pazienti è di primaria importanza nell’evitare complicazioni e nel supportare l’efficacia del trattamento.BACKGROUND Obesity is the most common nutritional disorder in western countries. The relationship between morbid obesity and medical conditions such as type 2 diabetes, hyperextensions,, osteo-arthritis or mental disorders is well established. The Bioenterics Intragastric Balloon (BIB®) System in association with restricted diet has been used for the short term treatment of morbid obesity. AIM OF THE STUDY To evaluate the tolerability and the efficacy of this device in obese patients in terms of weight loss. PATIENTS AND METHODS Patients were evaluated by a team made up of internist, dietician, endoscopist and psychologist for preoperative selection. The Bioenterics Intragastric Balloon (BIB®) was positioned with upper GI endoscopy. After positioning, patients were instructed to begin a 1000 Kcal diet. Patients were followed up monthly, for 6 months. Tolerability, weight loss and BMI reduction after BIB removal were evaluated. Statistical analysis was performed by means of Student’s Test; p < 0,05 was considered significant. RESULTS From November 2006 to December 2007 a total of 43 patients were selected and entered the study (19M / 24F ; mean age 44,4 ± 12 years; mean BMI 43,65 ± 8,67 Kg/m2). Complications related to endoscopy, balloon placement and removal were absent. Side effects were vomiting during first 3 days (88%) and occasionally heartburn and/or acid regurgitation (7%). After 6 months the mean BMI significantly (p < 0,001) lowered from 43,65 ± 8,67 to 37,93 ± 7,87 Kg/m2. CONCLUSIONS The results of this study show that treatment of obese patients with Bioenterics Intragastric Balloon is a safe, well tolerated and effective procedure- In association with appropriate diet is significantly effective in obese patients. Careful patient follow up is of primary importance in avoiding complications and supporting efficacy of treatment

Endoscopic full-thickness resection for suspected residual rectal neuroendocrine tumor and closure of the defect with a new suturing system

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Endosonographically guided gallbladder drainage to treat neoplastic jaundice after Roux-en-Y gastric resection

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Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

The α-Cyclodextrin/Moringin Complex: A New Promising Antimicrobial Agent against Staphylococcus aureus

Antimicrobial resistance is one of the major clinical concerns, making the discovery of new antimicrobial drugs desirable. Moringin (MOR), the major isothiocyanate produced from Moringa oleifera seeds, could represent an alternative therapeutic strategy to commonly used antibiotics. The aim of our study was to investigate the antimicrobial effect of MOR conjugated with &alpha;-cyclodextrin (MOR/&alpha;-CD), a complex with an improved solubility and stability in aqueous solutions. Our data demonstrated that MOR/&alpha;-CD was able to exert antimicrobial activity against the S. aureus reference strains (ATCC 25923, ATCC 6538, and ATCC BAA-977). Moreover, MOR/&alpha;-CD showed bacteriostatic effects (MIC = minimum inhibitory concentration = 0.5 mg/mL) and bactericidal properties (MBC = minimum bactericidal concentration = 1 mg/mL) against the overall assessed strains. In addition, MOR/&alpha;-CD showed bactericidal activity against the S. aureus strain ATCC BAA-977 after treatment with erythromycin (Ery), which induced clindamycin-resistance on the erm (A) gene. This evidence led us to assume that MOR/&alpha;-CD could be a promising antimicrobial agent against strains with the clindamycin-resistant phenotype (CC-resistant)

Treatment of Periodontal Ligament Stem Cells with MOR and CBD Promotes Cell Survival and Neuronal Differentiation via the PI3K/Akt/mTOR Pathway

Periodontal ligament mesenchymal stem cells (hPDLSCs), as well as all mesenchymal stem cells, show self-renewal, clonogenicity, and multi-tissue differentiation proprieties and can represent a valid support for regenerative medicine. We treated hPDLSCs with a combination of Moringin (MOR) and Cannabidiol (CBD), in order to understand if treatment could improve their survival and their in vitro differentiation capacity. Stem cells survival is fundamental to achieve a successful therapy outcome in the re-implanted tissue of patients. Through NGS transcriptome analysis, we found that combined treatment increased hPDLSCs survival, by inhibition of apoptosis as demonstrated by enhanced expression of anti-apoptotic genes and reduction of pro-apoptotic ones. Moreover, we investigated the possible involvement of PI3K/Akt/mTOR pathway, emphasizing a differential gene expression between treated and untreated cells. Furthermore, hPDLSCs were cultured for 48 h in the presence or absence of CBD and MOR and, after confirming the cellular viability through MTT (3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazoliumbromide) assay, we examined the presence of neuronal markers, through immunofluorescence analysis. We found an increased expression of Nestin and GAP43 (growth associated protein 43) in treated cells. In conclusion, hPDLSCs treated with Moringin and Cannabidiol showed an improved survival capacity and neuronal differentiation potential

Early onset of posterior reversible encephalopathy syndrome (PRES) during Cyclosporine-A infusion

[No abstract available