Functional diversity and metabolic response in benthic communities along an ocean acidification gradient.

Altered ocean chemistry caused by ocean acidification (OA) is expected to have negative repercussions at different levels of the ecological hierarchy, starting from the individual and scaling up to the community and ultimately to the ecosystem level. Understanding the effects of OA on benthic organisms is of primary importance given their relevant ecological role in maintaining marine ecosystem functioning. The use of functional traits represents an effective technique to investigate how species adapt to altered environmental conditions and can be used to predict changes in the resilience of communities faced with stresses associated with climate change. Artificial supports were deployed for 1-y along a natural pH gradient in the shallow hydrothermal systems of the Bottaro crater near Panarea (Aeolian Archipelago, southern Tyrrhenian Sea), to explore changes in functional traits and metabolic rates of benthic communities and the repercussions in terms of functional diversity. Changes in community composition due to OA were accompanied by modifications in functional diversity. Altered conditions led to higher oxygen consumption in the acidified site and the selection of species with the functional traits needed to withstand OA. Calcification rate and reproduction were found to be the traits most affected by pH variations. A reduction in a community's functional evenness could potentially reduce its resilience to further environmental or anthropogenic stressors. These findings highlight the ability of the ecosystem to respond to climate change and provide insights into the modifications that can be expected given the predicted future pCO2 scenarios. Understanding the impact of climate change on functional diversity and thus on community functioning and stability is crucial if we are to predict changes in ecosystem vulnerability, especially in a context where OA occurs in combination with other environmental changes and anthropogenic stressors.

The stakeholder's perception of socio-economic impacts generated by COVID-19 pandemic within the Italian aquaculture systems.

From the beginning of March 2020 and for the following two and half months, many European countries comprising Italy have been forced into an unprecedented lockdown, allowing only the opening of essential economic activities needed to address the problems created by the pandemic (e.g. sanitary, food provision). Like many sectors of the Italian economy, aquaculture has also slowed down due to the ongoing emergency and the consequent closure of business. In our study we provided a 'snapshot' of the socio-economic effects of the lockdown on the aquaculture sector in Italy, immediately following the adoption of the COVID-19 restrictions as they were perceived by the workers. Although it was surveyed for a short-time period, differences in perception have been detected both in relation to the type of aquaculture as well as to the geographic locations where farms were placed, partially reflecting the economic gaps already existing within the northern and the southern part of the country before the lockdown.

The aquaculture supply chain in the time of covid-19 pandemic: Vulnerability, resilience, solutions and priorities at the global scale.

The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.

Testosterone treatment is associated with reduced adipose tissue dysfunction and nonalcoholic fatty liver disease in obese hypogonadal men.

PURPOSE: In both preclinical and clinical settings, testosterone treatment (TTh) of hypogonadism has shown beneficial effects on insulin sensitivity and visceral and liver fat accumulation. This prospective, observational study was aimed at assessing the change in markers of fat and liver functioning in obese men scheduled for bariatric surgery. METHODS: Hypogonadal patients with consistent symptoms (n = 15) undergoing 27.63 ± 3.64 weeks of TTh were compared to untreated eugonadal (n = 17) or asymptomatic hypogonadal (n = 46) men. A cross-sectional analysis among the different groups was also performed, especially for data derived from liver and fat biopsies. Preadipocytes isolated from adipose tissue biopsies were used to evaluate insulin sensitivity, adipogenic potential and mitochondrial function. NAFLD was evaluated by triglyceride assay and by calculating NAFLD activity score in liver biopsies. RESULTS: In TTh-hypogonadal men, histopathological NAFLD activity and steatosis scores, as well as liver triglyceride content were lower than in untreated-hypogonadal men and comparable to eugonadal ones. TTh was also associated with a favorable hepatic expression of lipid handling-related genes. In visceral adipose tissue and preadipocytes, TTh was associated with an increased expression of lipid catabolism and mitochondrial bio-functionality markers. Preadipocytes from TTh men also exhibited a healthier morpho-functional phenotype of mitochondria and higher insulin-sensitivity compared to untreated-hypogonadal ones. CONCLUSIONS: The present data suggest that TTh in severely obese, hypogonadal individuals induces metabolically healthier preadipocytes, improving insulin sensitivity, mitochondrial functioning and lipid handling. A potentially protective role for testosterone on the progression of NAFLD, improving hepatic steatosis and reducing intrahepatic triglyceride content, was also envisaged. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02248467, September 25th 2014.

Internal hernia after mini-gastric bypass: Myth or reality?

The mini-gastric bypass (MGBP) is becoming an increasingly popular procedure worldwide. It is based on an "omega" reconstruction, resulting in a single anastomosis and in potential shortening of operative time. Internal hernia represents a potentially life-threatening complication after laparoscopic Roux-en-Y gastric bypass, but it has not yet been reported after a mini-gastric bypass. We herein describe, for the first time, a case of internal hernia after this surgery.

Contenidos en el área de salud y competencias específicas en el ciclo de nivelación de la Facultad de Ciencias Médicas / Contents in the health section and specific competences in the leveling course in the School of Medicine / Conteúdos na área de saúde e habilidades específicas no ciclo de nivelamento da Faculdade de Ciências Médicas

Las instituciones universitarias para lograr excelencia académica en los futuros profesionales exigen considerar a la educación con un signifi cado primordial. El presente trabajo identifi ca los contenidos en el área de salud en los materiales de ejercitación del Ciclo de Nivelación y las competencias específi cas en los diferentes Ejes Temáticos, desde la perspectiva de los profesores. Para identifi car los contenidos del área de salud se aplicó un instrumento con los ítems: objetivos, contenidos, actividades y bibliografía. Para indagar la perspectiva de los profesores se implementó un cuestionario a ocho informantes claves, que incluyó la valoración de las competencias específi cas en el área a su cargo. De acuerdo a lo trabajado, se reconoce la importancia de articulación entre educación y salud, en términos de vincular experiencia-formación de los docentes, conocimientos de los estudiantes y contenidos específi cos en relación al proceso salud-enfermedad, porque se transforma en retroalimentación para los Ciclos de Nivelación.

In order to achieve academic excellence in their future professionals, university institutions require the consideration of education with a fundamental meaning. This work identifi es the contents in the health section of the exercise material included in the Leveling Course and the specifi c competences in the different Main Topics, from the teachers´perspective. An instrument including the following items: objectives, contents, activities and biography was applied to identify the contents in the health section. To inquire about the teachers’ perspective a questionnaire was used with eight key informants; it included the assessment of specifi c competences in the area they are in charge of. As a conclusion, it is observed that it is important to articulate education and health, in terms of linking teachers’ experience-training, students’ knowledge and specifi c contents regarding the process health-illness, since it becomes feedback for the Leveling Courses.

As instituições universitárias, visando a excelência acadêmica nos futuros profi ssionais, exigem considerar a educação como tendo um signifi cado fundamental. Este documento identifi ca os conteúdos na área da saúde dos materiais de treinamento do Ciclo de Nivelamento e as competências específi cas nos diferentes Eixos Temáticos a partir da perspectiva dos professores. Para identifi car os conteúdos da área de saúde aplicou-se um instrumento composto dos itens: objetivos, conteúdos, atividades e bibliografi a. Para pesquisar a perspectiva dos professores aplicou-se um questionário a oito docentes-chave, que incluiu a avaliação de competências específi cas na área da sua responsabilidade.. De acordo com o trabalho, pode-se reconhecer a importância da articulação entre educação e saúde, em termos de articular a experiência-formação dos professores, os conhecimentos dos estudantes e os conteúdos específi cos em relação ao processo saúde-doença, pois ele torna-se em retroalimentacão para os Ciclos de Nivelamento.

Profesionales de la Salud y Formación Docente: Una propuesta de Curriculum integrado / Profissionais de saúde e formação de professores: uma proposta de currícula integrada / Health Professionals And Teacher Training: Integrated Syllabus Proposal

La presente investigación tiene el propósito de describir el proceso de formación en investigación-acción efectuada en la integración realizada por dos cátedras de la Carrera del Profesorado Universitario: Investigación educativa y Didáctica Especial producto de siete años de trabajo.Dicho proceso se sostiene a partir del reconocimiento de problemáticas planteadas por los alumnos-profesionales,en su trabajo como docentes. La construcción del problema de investigación requiere de diferentes estrategias pedagógicas. La metodología se basó en el enfoque de investigación-acción. Los resultados confirman que la integración inter cátedras un elemento clave para transformar el quehacer universitario y es una alternativa para fomentar y desarrollar la investigación científica que contribuya al mejoramiento y transformación de la sociedad, como uno de los objetivos de la Universidad Católica de Córdoba a la par que se constituye en una estrategia para el acuerdo, los consensos, la innovación e investigación que están en consonancia con la misión institucional...

The purpose of this research is to describe the training process in research-action that tookplace in the integration of Educational Research and Special Didactics; two chairs of thecourse of studies University Teaching, result of seven-year-work. Said process arises from theacknowledgment of issues proposed by students-professionals in their work as teachers. Theconstruction of the research problem requires different pedagogic strategies. Methodologywas based on the research-action approach. Results confi rm that inter-chair integrationis a key factor to transform university tasks and an alternative to encourage and developscientifi c research helping to improve and transform society as one of the objectives on theCatholic University of Cordoba. At the same time, it is becoming a strategy for agreement,consensus, innovation and investigation, consistent with the institutional mission...

Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba.

This study describes and analyses the consumption of psychoactive substances in educational institutions, the school environment conditions and its relation to the school standing of the students. In the first stage, a quantitative evaluation was performed, based on the records of the Second National Survey of Secondary School Students carried out in Córdoba in 2005; the second stage used a qualitative approach. A multistage probabilistic sample of 4593 students was used for the quantitative assessment. The analysis comprised summary measurements, multivariate and factorial correspondence analysis, in all cases with a significance level of p < 0.05. For the qualitative stage, an ethnographic approach was applied. The state schools were chosen using an intentional, cumulative and sequential sampling method. Ten in-depth interviews were carried out to gather qualitative data that was analyzed using the comparative constant method. Results evince that consumption is lower among morning-shift students and that grade repetition and behavior problems are associated to consumption of illegal drugs. Furthermore, it was detected that students in night-shift schools with low academic and disciplinary demand standards have a higher probability of consumption. It is clear that as academic standards decrease, consumption increases.

Use of the parenteral antibiotic Ertapenem as short term prophylaxis in bariatric surgery: a pharmaco-kinetic-pharmacodynamic study in class III obese female patients.

BACKGROUND: The objective of this study was to determine the pharmacokinetics-pharmacodynamics (PK/PD) of Ertapenem in extremely obese female patients (Body Mass Index [BMI] ≥ 40 kg/m²) undergoing bariatric surgery. METHODS: Ten patients received 1 g intravenous Ertapenem 0.5 h prior to surgery as short term prophylaxis. Serum Ertapenem concentrations were determined at baseline, at the end of infusion (30 minutes), then at 1, 2, 4, 8, 12 and 24 hours postinfusion. In patients in whom a liver biopsy was necessitated by clinical need, Ertapenem liver concentrations were determined through intraoperative biopsies at 1 and 2 h postadministration. Peritoneal Ertapenem concentrations were determined in drainage fluid samples collected during the 4-8, 8-12, and 12-24 h intervals after Ertapenem administration. A Monte Carlo simulation was performed to estimate the probability of achieving free drug levels above the minimum inhibitory concentration (fT>MIC) for at least 20% and 40% of the dosing interval as PK/PD targets. RESULTS: Peak drug concentration and 24-h area under the concentration-time curve (AUC) were found to be 191.9 ± 37.4 mg/L and 574.3 ± 110.5 mg·h/L, respectively. Ertapenem liver/serum concentration ratios were 6% at 1 h and 5% at 2 h. Drug concentrations in peritoneal fluid were 28.2 ± 6.4 mg/L at 4-8h, declined to 15.2 ± 5.9 at 8-12h and fell further to 4.79 ± 0.2 mg/L at 12-24 h post-administration. The probability to reach the desired PK/PD targets were never reached at any MICs >0.25 µg/mL with a 90% probability. CONCLUSION: Our data suggest that in extremely obese female patients, the standard dose of 1 g i.v. Ertapenem as short term prophylaxis may not provide optimal clinical levels of free drug for prevention of surgical site infections.

Osteocalcin increase after bariatric surgery predicts androgen recovery in hypogonadal obese males.

OBJECTIVE: Bone modulates testis function through osteocalcin (OCN) production. This paper assesses the association between serum OCN and androgen production recovery in morbidly obese males at 9 months after bariatric surgery. SUBJECTS: A cohort of n=103 obese males with mean±s.d. body mass index (BMI) 47.7±8.2 kg m(-2), age 42±11 years, consisting of n=76 patients undergoing gastric bypass and n=27 in the waiting list for surgery. RESULTS: At 9 months from surgery, a significant increase was observed in mean±s.d. total OCN (tOCN=10.4±10.3 ng ml(-1), P<0.001) and undercarboxylated OCN (ucOCN=5.4±3.7 ng ml(-1), P<0.001), total testosterone (TT, 5.6±6.5 nM, P<0.001) and calculated free testosterone (cFT, 0.035±0.133 nM, P<0.006), sex hormone binding globulin (SHBG, 21.2±16.7 nM, P<0.001) and decrease in estradiol (E2, -30.1±51.9 pM, P<0.001) levels only in operated patients, with a significant reduction in BMI (24%) and waist (20%). A positive correlation existed between tOCN and ucOCN (age-adjustment (age-adj.): ß=0.692, P<0.001) and their variations (age-adj.: ß=0.629, P<0.001) after surgery. Multivariate analysis in operated patients showed a significant positive association between variations in tOCN and TT (age-adj.: ß=0.289, P=0.012), SHBG (age-adj.: ß=0.326, P=0.005) but not with cFT variation. tOCN, but not luteinizing hormone (LH) variation was the only significant predictive factor of cFT recovery in the hypogonadal (TT<12 nM) operated subjects even after age- and BMI-adjustment (adj.: ß=0.582, P<0.05). cFT improvement was significantly higher when considering operated patients with tOCN increase (0.045±0.123 vs -0.02±0.118 nM, P=0.015), hypogonadism (0.059±0.111 vs -0.059±0.138 nM, P=0.002) and younger than 35 years (0.102±0.108 vs -0.019±0.123 nM, P=0.009). CONCLUSION: OCN recovery observed after bariatric surgery is significantly associated with cFT improvement independently of BMI variation and age in hypogonadal morbidly obese males.

Mortalidad por trastornos mentales y por causas externas: análisis de una Década en Argentina / Mortality due to mental disorders and external causes: analysis of a decade in Argentina

Objetivo: analizar las tasas de mortalidad de Trastornos Mentales y del Comportamiento (TMyC) y de las Causas Externas (CE) en las Estadísticas Vitales de Argentina, periodo 2000-2009.Metodología: se utilizó las bases de datos de defunciones, Argentina, años 2000 a 2009, de la Dirección de Estadísticas e Información en Salud Ministerial. Se construyeron tasas generales y específicas. Las estimaciones poblacionales, se obtuvieron a partir del aplicativo AGEINT. Según la distribución de la variable, se utilizó análisis de la varianza o test no paramétricos. Resultados: se observa un comportamiento disímil de la tasa de mortalidad por TMyC según sexo, pero con un comportamiento similar por cada año. Los TMyC y las CE, comprometen a la población adulta del país, con tasas mayores en el grupo de varones.Conclusión: tener en cuenta el impacto de los TMyC y CE, permite diseñar políticas públicas en salud adecuadas a las realidades de cada contexto

Objective: To analyze mortality rates due to mental and behavioral disorders (MBD) and external causes (EC) using Vital Statistics of Argentina, 2000-2009.Methods: Mortality data 2000-2009 were obtained from the Bureau of Statistics and Information, Ministry of Health, Argentina. General and specific rates were set up. Population estimates were obtained from the AGEINT application. According to the distribution of the variable, analysis of variance or nonparametric tests were used.Results: Dissimilar MBD mortality rates according to sex were observed, but with a similar pattern each year. The MBD and EC affect the adult population of the country, with higher rates in the male group.Conclusion: Taking into account the impact of MBD and EC, allows the design of public policies suitable to the realities of each health context

Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba / Consumption of psychoactive substances in educational institutions: an inquiry into the state of affairs in the schools of Córdoba.

This study describes and analyses the consumption of psychoactive substances in educational institutions, the school environment conditions and its relation to the school standing of the students. In the first stage, a quantitative evaluation was performed, based on the records of the Second National Survey of Secondary School Students carried out in Córdoba in 2005; the second stage used a qualitative approach. A multistage probabilistic sample of 4593 students was used for the quantitative assessment. The analysis comprised summary measurements, multivariate and factorial correspondence analysis, in all cases with a significance level of p < 0.05. For the qualitative stage, an ethnographic approach was applied. The state schools were chosen using an intentional, cumulative and sequential sampling method. Ten in-depth interviews were carried out to gather qualitative data that was analyzed using the comparative constant method. Results evince that consumption is lower among morning-shift students and that grade repetition and behavior problems are associated to consumption of illegal drugs. Furthermore, it was detected that students in night-shift schools with low academic and disciplinary demand standards have a higher probability of consumption. It is clear that as academic standards decrease, consumption increases.

Hypogonadism as a new comorbidity in male patient's selection for bariatric surgery: towards an extended concept of metabolic surgery?

Hypogonadism and subfertility can be frequently associated to obesity. These endocrine alterations may have consequences in the health and quality of life of obese men since they may result in impaired fertility and poor sexual life. As many clinical reports suggest, weight loss can ameliorate hypogonadism and, more generally, alterations in sex hormones. This effect is evident even when weight loss is induced by bariatric surgery. The evidence that hypogonadism in morbidly obese patients can regress after bariatric surgery should lead us to consider it as a modifiable comorbidity associated to obesity. This would have as a consequence that obese male patients with symptomatic hypogonadism could be candidates for bariatric surgery even with a BMI < 40 kg/m(2). Controlled clinical trials, involving obese hypogonadal males, should be encouraged.

Bayesian denoising in digital radiography: a comparison in the dental field.

We compared two Bayesian denoising algorithms for digital radiographs, based on Total Variation regularization and wavelet decomposition. The comparison was performed on simulated radiographs with different photon counts and frequency content and on real dental radiographs. Four different quality indices were considered to quantify the quality of the filtered radiographs. The experimental results suggested that Total Variation is more suited to preserve fine anatomical details, whereas wavelets produce images of higher quality at global scale; they also highlighted the need for more reliable image quality indices.

Hospitalización por trastornos mentales y consumo de sustancias en adolescentes: 2005-2006 / Hospitalization due to mental disorders and substance consumption in argentine adolescents: 2005-2006

Objetivo: Determinar la prevalencia de trastornos mentalesy del comportamiento como causadehospitalización en lapoblación adolescente de 10 a 19 años en Argentina en elperíodo 2005 -2006.Metodología: estudio observacional, analítico ytransversal, se utilizaron las Bases de Datos delosInformesEstadísticos de Egresos Hospitalarios (IEH) de la DireccióndeEstadística e Información de Salud del Ministerio deSalud de la Nación, años 2005-2006. Los datos fueronanalizados según sexo, edad y causa de egreso hospitalario. Elprocesamiento estadístico de los datos consistió en test dechi–cuadrado, Mantel Haenzel o test de Fisher,p<0,05.Resultados: el 2% de los egresos hospitalarios fueron porTrastornos Mentales y del Comportamiento (TMyC).LosTMyC de mayor frecuencia para el grupo de 10-14 años fueron:trastornos neuróticos (29,89%), consumo de sustancias(23,49%) (p<0,001) y trastornos del comportamiento deinicio en la infancia (15,40%) y para el grupo de 15-19años fueron: consumo de sustancias (30,94%) (p<0,001),alcohol la más frecuente, trastornos neuróticos (21,04%) yesquizofrenia (17,34%) (p<0,001). La distribución por sexosy edad mostró al consumo de sustancias (p< 0,0001) comolapatología más frecuente en varones y trastornos neuróticos(p< 0,0001) en mujeres de ambos grupos de edad.

Objective: To determine the prevalence of behavioral and mental disorders as the causeof hospitalization in adolescent population from age 10 to 19 in Argentina in the period2005-2006.Method: Observational, analytical and transversal study. The databases of StatisticalRecords of Hospital Discharge from the Department of Health Statistics and Information ofthe National Ministry of Health, years 2005-2006, were used. Data were analyzed accordingto sex, age and cause of hospital discharge. The statistical processing of data was done withthe chi-squared test, Mantel Haenzel or Fisher’s test,p<0.05.Results: 2% of hospital discharges were for Behavioral and Mental Disorders. The mostfrequent of these disorders for the age group 10-14 were: neurotic disorders (29.89%),substance consumption (23.49%) (p<0.001), and behavioral diseases starting in childhood(15.40%). For the age group 15-19 the most frequent were: substance consumption(30.94%) (p<0,001) -alcohol the most frequent-, neurotic disorders (21.04%) andschizophrenia (17.34%) (p<0.001). Distribution according to sex and age showed drugconsumption (p< 0.0001) as the most frequent pathology among boys and neuroticdisorders (p< 0.0001) among girls of both age groups.

Analisis de estrategias de atencion primaria de salud en el municipio de Malvinas Argentinas: un abordaje cuanti-cualitativo / Analysis of primary health service strategies in the Malvinas Argentina Community: a quantitative and qualitative approach

La situación de salud en Argentina revela la necesidad deevaluar la capacidad de gestión de centros de primer nivel deatención y el desarrollo de redes asistenciales. El objetivo deeste proyecto fue evaluar las estrategias de atención primariaen los centros de salud de la comunidad de Malvinas Argentinas.La metodología consistió en una fase diagnóstica, una de intervención y validación de la propuesta y una de análisis de resultados, abordada con metodología cuantitativa y cualitativa.Este trabajo movilizó el abordaje de la salud desde la atención primaria y el reconocimiento de los propios centros de generar estrategias para brindar atención efectiva y eficiente a pesardel deterioro socioeconómico de la comunidad. Además permitióidentificar el funcionamiento de una red comunitaria, en la cual será necesario afianzar el trabajo respecto a la educación en salud. El impacto de la presente investigación está relacionado a las vinculaciones que se generaron entre las institucionesinvolucradas.

Obese teenagers treated by Lap-Band System: the Italian experience.

BACKGROUND: Little is known about obesity surgery in young and adolescent patients. The aim of this study is to evaluate results of laparoscopic adjustable gastric banding in obese teenagers. METHODS: Patients < or = 19 years old selected from the database of the Italian Collaborative Study Group for Lap-Band were analyzed according to mortality, comorbidities, laparotomic conversion, intra- and postoperative complications, body mass index (BMI), and % excess weight loss (EWL) at different times of follow-up. Data were expressed as mean +/- SD. RESULTS: Fifty-eight (1.5%) of 3813 patients who underwent operation with the Lap-Band System were < or = 19 years old: 47F/11M; mean age, 17.96 +/- 0.99 years (range, 15-19); mean BMI, 46.1 +/- 6.31 Kg/m2 (range, 34.9 - 69.25); mean % excess weight, 86.4 +/- 27.1 (range, 34 - 226.53). Sixteen (27.5%) of the 58 patients were superobese (BMI > or = 50). In 27/58 (46.5%) patients, 1 or more comorbidities were diagnosed. Mortality was absent. Laparotomic conversion was necessary in 1 patient with gastric perforation on the anterior wall. Overall postoperative complications occurred in 6/58 (10.3%). The band was removed in 6/58 (10.3%) patients for gastric erosion (3 patients), psychologic, intolerance (2 patients), and in the remaining patient was converted 2 years after surgery (BMI 31) to gastric bypass or gastric pouch dilatation. Patient follow-up at 1, 3, 5, and 7 years was 48/52 (92.3%), 37/42 (88.1%), 25/33 (75.7%), and 10/10, respectively. At these times, mean BMI was 35.9 +/- 8.4, 37.8 +/- 11.27, 34.9 +/- 12.2, and 29.7 +/- 5.2 Kg/m2. Mean %EWL at the same time was 45.6 +/- 29.6, 39.7 +/- 29.8, 43.7 +/- 38.1, and 55.6 +/- 29.2. Five/25 (20%) patients had < or = 25% EWL at 5 years follow-up, while none of the 10 patients subject to follow-up at 7 years had < or = 25% EWL. CONCLUSIONS: Lap-Band System is an interesting option for teenagers suffering obesity and its related comorbidities, which deserves further investigation.

Italian Group for Lap-Band System: results of multicenter study on patients with BMI < or =35 kg/m2.

BACKGROUND: The Lap-Band System is the most common bariatric operation world-wide. Current selection criteria do not include patients with BMI < or = 35. We report the Italian multicentre experience with BMI < or = 35 kg/m(2) over the last 5 years. PATIENTS AND METHODS: Data were obtained from 27 centres involved in the Italian Collaborative Study Group for Lap-Band System. Detailed information was collected on a specially created electronic data sheet (MS Access 2000) on patients operated in Italy since January 1996. Items regarding patients with BMI < or = 35 were selected. Data were expressed as mean +/- SD except as otherwise indicated. RESULTS: 225 (6.8%) out of 3,319 Lap-Band patients were recruited from the data-base. 15 patients, previously submitted to another bariatric procedure (BIB =14; VBG= 1) were excluded. 210 patients were eligible for study (34M/176F, mean age 38.19+/-11.8, range 17-66 years, mean BMI 33.9+/-1.1, range 25.1-35 kg/m(2), mean excess weight 29.5+/-7.1, range 8-41). 199 comorbidities were diagnosed preoperatively in 55/210 patients (26.2%). 1 patient (0.4%) (35 F) died 20 months postoperatively from sepsis following perforation of dilated gastric pouch. There were no conversions to laparotomy. Postoperative complications presented in 17/210 patients (8.1%). Follow-up was obtained at 6, 12, 24, 36, 48 and 60 months. At these time periods, mean BMI was 31.1+/-2.15, 29.7+/-2.19, 28.7+/-3.8, 26.7+/-4.3, 27.9+/-3.2, and 28.2+/-0.9 kg/m(2) respectively. Co-morbidities completely resolved 1 year postoperatively in 49/55 patients (89.1%). At 60 months follow-up, only 1 patient (0.4%) has a BMI >30. CONCLUSIONS: Although surgical indications for BMI < or = 35 remain questionable, the Lap-Band in this study demonstrated that all but 1 patient achieved normal weight, and most lost their co-morbidities with a very low mortality rate.

The Italian Group for LAP-BAND: predictive value of initial body mass index for weight loss after 5 years of follow-up.

BACKGROUND: Laparoscopic of the LAP-BAND System placement stage of obesity is a safe operation, but its indication in terms of stage of obesity is controversial. The aim of this study was to evaluate the 5 years stage of obesity results for weight loss in patients with varying preoperative ranges of body mass index (BMI). METHODS: Data were obtained from the Italian Collaborative Study Group for LAP-BAND System (GILB) registry. Detailed information was collected on a specifically created database (MS Access 2000) for patients operated on in Italy from January 1996 to 2003. Patients operated on between January 1996 and December 1997 were allocated to four groups according to preoperative BMI range: 30-39.9 kg/m(2) (group A), 40-49.9 kg/m(2) (group B), 50-59.9 kg/m(2) (group C), and =60 kg/m(2) (group D) percent estimated weight loss respectively. Postoperative complications, mortality, BMI, BMI loss, and (%EWL) were considered in each group. Data are expressed as mean +/- SD, except as otherwise indicated. Statistical analysis was done by means of Fisher's exact test, and p < 0.05 was considered significant. RESULTS: After 5 years from LAP-BAND System surgery, 573 of 3,562 patients were eligible for the study. One hundred fifty-five of 573 (27.0%) were lost to follow-up, 24 of 418 (5.7%) underwent band removal due to complications (gastric pouch dilation, band erosion), eight of 418 (1.9%) were converted to other bariatric procedures, five of 418 (1.2%) died of causes not related to the operation or the band, and 381 of 573 (66.5%) were available for follow-up. Based on 96, 214, 64, and seven patients their preoperative BMI, Were allocated to groups A, B, C, and D, respectively. At time of follow-up mean BMI was 27.5 +/- 5.2 in group A, 31.6 +/- 4.7 in group B, 37.6 +/- 17.3 in group C, and 41.4 +/- 6.9 kg/m(2) in group D. Mean BMI loss was 9.8 +/- 5.4, 12.9 +/- 5.2, 15.8 +/- 8.1, and 23.2 +/- 4.9 kg/m(2), respectively, in groups A, B, C, and D. Mean %EWL at the same time was 54.6 +/- 32.3 in group A, 54.1 +/- 17.2 in group B, 51.6 +/- 35 in group C, and 59.l +/- 17.1 in group D. CONCLUSION: Initial BMI in this series did not correlate with %EWL 5 years after the operation. In fact %EWL was almost the same in each group, independent of preoperative weight. Initial BMI was an accurate indicator of the results obtained 5 years after LAP-BAND in group C (50-59.9 kg/m(2)) and D (=60 kg/m(2)) patients, who remained morbidly obese despite their %EWL.