Pancreatic exocrine insufficiency after bariatric surgery

Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult. Steatorrhea, weight loss, maldigestion and malabsorption are pathognomonic for both clinical conditions. Altered anatomy after bypass surgery can make the diagnostic process even more difficult. Fecal elastase-1 (FE1) is a useful diagnostic test. PEI should be considered in all patients after bariatric surgery with prolonged gastrointestinal complaints that are suggestive of maldigestion and/or malabsorption. Appropriate pancreatic enzyme replacement therapy should be part of the treatment algorithm in patients with confirmed PEI or symptoms suggestive of this complication

Uporedna karakterizacija sastava i nutritivne vrednosti hladno presovanog i rafinisanog ulja semenki grožđa

In this paper the comparative analysis of fatty acid composition and nutritional value of cold pressed oils of white and red grap seeds are compared to refined grape seed oil. The results showed that there are certain differences between cold pressed and refined oil, especially in nutritional values. Fatty acid composition of all samples was common for this type of oil, however, cold-pressed oils, both from the seeds of white and red grapes, had a significantly higher content of carotenoids and chlorophylls, as well as total tocopherols. On the other hand, refined oil was slightly enriched with phenolic compounds.U ovom radu izvršena je uporedna analiza sastava masnih kiselina i odabranih pokazatelja nutritivne vrednosti hladno presovanih ulja semenki belog i crnog grožđa u odnosu na rafinisano ulje semenki grožđa. Rezultati su pokazali da postoje izvesne razlike između hladno presovanih i rafinisanog ulja, posebno po nutritivnoj vrednosti. Sastav masnih kiselina svih uzoraka je bio uobičajen za ovu vrstu ulja, međutim, hladno presovana ulja, kako od semenki belog tako i crnog grožđa, imala su znatno veći sadržaj karotenoida i hlorofila, kao i ukupnih tokoferola. Nasuprot tome, fenolnim jedinjenjima je nešto bogatije bilo rafinisano ulje

Get More for Less in Decentralized Learning Systems

Decentralized learning (DL) systems have been gaining popularity because they avoid raw data sharing by communicating only model parameters, hence preserving data confidentiality. However, the large size of deep neural networks poses a significant challenge for decentralized training, since each node needs to exchange gigabytes of data, overloading the network. In this paper, we address this challenge with JWINS, a communication-efficient and fully decentralized learning system that shares only a subset of parameters through sparsification. JWINS uses wavelet transform to limit the information loss due to sparsification and a randomized communication cut-off that reduces communication usage without damaging the performance of trained models. We demonstrate empirically with 96 DL nodes on non-IID datasets that JWINS can achieve similar accuracies to full-sharing DL while sending up to 64% fewer bytes. Additionally, on low communication budgets, JWINS outperforms the state-of-the-art communication-efficient DL algorithm CHOCO-SGD by up to 4x in terms of network savings and time

Incorporation of capric acid in pumpkin seed oil by sn-1,3 regioselective lipase-catalyzed acidolysis

Structured lipids (SLs) are novel triacylglycerols obtained by changing the native fatty acid (FA) profiles or by the incorporation of a new desired FA in the acylglycerol backbone. These modified fats present important medical and functional properties for food applications. This work aimed to synthetize a MLM-type SL, which consists of triacylglycerols containing a medium-chain FA (M) at sn-1,3 positions and a long-chain FA (L) at sn-2 position, by acidolysis of pumpkin seed oil with capric acid, catalyzed by a commercial lipase preparation from Thermomyces lanuginosa (Lipozyme TL IM). Reactions were performed at 45 degrees C, in solvent-free media, at 1: 2 molar ratio (pumpkin seed oil: capric acid) and a fixed amount of immobilized lipase of 5%, 10%, 15% or 20%. Incorporations of C10: 0 increased with time up to 31 h (29.9 +/- 0.7 mol-%) when 5% lipase load was used. Significant differences were only observed between the results obtained with 5 and 20% of biocatalyst load. The subsequent experiment was carried out with 5% lipase load, at 45 degrees C, 1: 2 molar ratio and in the presence of n-hexane. The results showed slightly higher incorporation yields in the presence of solvent, namely at 48 h-reaction (34.7 +/- 1.0 mol-%). However, since the structured lipids are to be used in food products, together with environmental and economic concerns, solvent-free systems are preferred. In this study, the synthesis of a MLM-type SL from pumpkin seed oil for food uses was well succeeded

Bridging clinic: The initial medical management of patients with newly diagnosed pancreatic cancer

Pancreatic cancer is the 11th most common cancer in the UK and has the worst prognosis of any tumour with minimal improvements in survival over recent decades. As most patients are either ineligible for surgery or may decline chemotherapy, the emphasis is on control of symptoms and management of complications such as poor nutritional status. The time period between informing the patient of their diagnosis and commencing cancer treatments presents a valuable opportunity to proactively identify and treat symptoms to optimise patients’ overall well-being. The ‘bridging clinic’, delivered by a range of healthcare professionals from gastroenterologists to nurse practitioners, can provide this interface where patients are first informed of their diagnosis and second supportive therapies offered. In this article, we provide a structure for instituting such supportive therapies at the bridging clinic. The components of the clinic are summarised using the mnemonic INDASH (Information/Nutrition/Diabetes and Depression/Analgesia/Stenting/Hereditary) and each is discussed in detail below

The Clinical Utility of Soluble Serum Biomarkers in Autoimmune Pancreatitis: A Systematic Review

Autoimmune pancreatitis (AIP) is a rare etiological type of chronic pancreatitis. The clinical and radiological presentation of AIP often resembles that of pancreatic cancer. Identifying non-invasive markers for their early distinction is of utmost importance to avoid unnecessary surgery or a delay in steroid therapy. Thus, this systematic review was conducted to revisit all current evidence on the clinical utility of different serum biomarkers in diagnosing AIP, distinguishing AIP from pancreatic cancer, and predicting disease course, steroid therapy response, and relapse. A systematic review was performed for articles published up to August 2021 by searching electronic databases such as MEDLINE, Web of Science, and EMBASE. Among 5123 identified records, 92 studies were included in the qualitative synthesis. Apart from immunoglobulin (Ig) G4, which was by far the most studied biomarker, we identified autoantibodies against the following: lactoferrin, carboanhydrase II, plasminogen-binding protein, amylase-α2A, cationic (PRSS1) and anionic (PRSS2) trypsinogens, pancreatic secretory trypsin inhibitor (PSTI/SPINK1), and type IV collagen. The identified novel autoantigens were laminin 511, annexin A11, HSP-10, and prohibitin. Other biomarkers included cytokines, decreased complement levels, circulating immune complexes, N-glycan profile changes, aberrant miRNAs expression, decreased IgA and IgM levels, increased IgE levels and/or peripheral eosinophil count, and changes in apolipoprotein isoforms levels. To our knowledge, this is the first systematic review that addresses biomarkers in AIP. Evolving research has recognized numerous biomarkers that could help elucidate the pathophysiological mechanisms of AIP, bringing us closer to AIP diagnosis and its preoperative distinction from pancreatic cancer

The effect of microwave pre-treatment of rapeseed on the degradation kinetics of lipophilic bioactive compounds of the oil during storage

This study examined the storage stability of tocochromanols and carotenoids in the oils prepared from microwave pre-treated (MV) rapeseeds (2-10 min, 800W) during storage at 20 °C for 12 months. In line with lipophilic antioxidant degradation throughout the storage period, changes in the antioxidant capacity of the oil were monitored. Microwaving significantly affected the concentration of lipophilic antioxidants in the oil. After 10 min of MV pre-treatment the highest content of total tocochromanols (76.64 mg/100g) was achieved, whereas a maximum carotenoid concentration (861.28 μg/100g) was obtained following 6 min seed MV pre-treatment. The degradation kinetics for the tocochromanols and carotenoids followed a zero-order kinetic model. From the kinetic analysis, it was shown that the degradation rate constant (k) of both tocochromanols and carotenoids decreased with longer seed exposure to MV radiation. The kinetics of antioxidant capacity degradation during the storage of oils followed a zero-order reaction. The rate of antioxidant capacity degradation in the control oil was higher (k=9.1 x 10-2 mmol TEAC/l/month) compared with oils prepared from MV pre-treated seeds (k=6.8-8.0 x 10-2 mmol TEAC/l/month)

Silver activation on thin films of Ag-ZrCN coatings for antimicrobial activity

Nowadays, with the increase of elderly population and related health problems, knee and hip joint prosthesis are being widely used worldwide. However, failure of these invasive devices occurs in a high percentage thus demanding the revision of the chirurgical procedure. Within the reasons of failure, microbial infections, either hospital or subsequently-acquired, contribute in high number to the statistics. Staphylococcus epidermidis (S. epidermidis) has emerged as one of the major nosocomial pathogens associated with these infections. Silver has a historic performance in medicine due to its potent antimicrobial activity, with a broad-spectrum on the activity of different types of microorganisms. Consequently, the main goal of this work was to produce Ag-ZrCN coatings with antimicrobial activity, for the surface modification of hip prostheses. Thin films of ZrCN with several silver concentrations were deposited onto stainless steel 316 L, by DC reactive magnetron sputtering, using two targets, Zr and Zr with silver pellets (Zr + Ag target), in an atmosphere containing Ar, C2H2 and N2. The antimicrobial activity of the modified surfaces was tested against S. epidermidis and the influence of an activation step of silver was assessed by testing samples after immersion in a 5 % (w/v) NaClO solution for 5 minutes. The activation procedure revealed to be essential for the antimicrobial activity, as observed by the presence of an inhibition halo on the surface with 11 at. % of Ag. The morphology analysis of the surface before and after the activation procedure revealed differences in silver distribution indicating segregation/diffusion of the metallic element to the films surface. Thus, the results indicate that the silver activation step is responsible for an antimicrobial effect of the coatings, due to silver oxidation and silver ion release.IF acknowledges the financial support of FCT-Fundacao para a Ciencia e a Tecnologia through grant SFRH/BD/71139/2010.This research is partially sponsored by FEDER funds through the program COMPETE-Programa Operacional Factores de Competitividade and by Portuguese national funds through FCT-Fundacao para a Ciencia e a Tecnologia, under the projects ANTIMICROBCOAT-PTDC/CTM/102853/2008 and in the framework of the Strategic Projects PEST-C/FIS/UI607/2011, and PEST-C/EME/UI0285/2011.The authors thank the FCT Strategic Project PEST-OE/EQB/LA0023/2013 and the Project "BioHealth-Biotechnology and Bioengineering approaches to improve health quality", Ref. NORTE-07-0124-FEDER-000027, co-funded by the Programa Operacional Regional do Norte (ON.2 - O Novo Norte), QREN, FEDER. The authors also acknowledge the project "Consolidating Research Expertise and Resources on Cellular and Molecular Biotechnology at CEB/IBB", Ref. FCOMP-01-0124-FEDER-027462