Les Planàries d'aigües dolces a Catalunya i les illes Balears. I. Clau sistemàtica i distribució geogràfica

The geographical distribution of freshwater planarians in Catalonia and the Balearic Islands has been studied from old and new records. Up to now, seven species have been found in Catalonia throughout the 44 localities studied, whereas only three species are present in the 13 localities studied in the Balearic Islands. The species and the geographical pattern found are similar to the published European records. The criteria for a correct diagnosis of planarian species are assessed especially when dealing with complex groups like the subgenera Schmidtea and the old «gonocephala» group. We stress the need to study the karyotypes to diagnose correctly some of the present species and to discover new races and species hidden under a similar external appearance. Taking into account these considerations a key is provided to assist clasification of these organisms. Finally, a pledge is made to stimulate the flow of sound information to add in a future work

Endoscopic diverticulectomy with platelet-rich plasma of intraluminal duodenal diverticulum

Background: Procedure-related bleeding remains a common complication after endoscopic diverticulectomy of intraluminal duodenal diverticulum (IDD). The optimal endoscopic approach to IDD has not been established. Platelet-rich plasma (PRP) has proven biological properties to reduce risk of bleeding. Materials and Methods: The authors describe a novel technique in which endoscopic diverticulectomy was performed with prior submucosal injection of PRP (IRB approval PT-16-002). Case Report: A 62-year-old woman with a large IDD like a “windsock” underwent endoscopic diverticulectomy with PRP obtained from a sample of patient’s blood. IDD was resected with EMR technique using a standard polypectomy snare. No immediate or delayed bleeding was noted. Follow-up endoscopy 3 months later revealed complete mucosal healing and open communication to the distal duodenum. Conclusion: Endoscopic diverticulectomy with PRP is an option in patients with IDDMedicin

Comparative study of electrical and rheological properties of different solutions used in endoscopic mucosal resection

Background and Aim: The study of electrical and rheological properties of solutions to carry out endoscopic resection procedures could determinate the best candidate. An ex vivo study with porcine stomachs was conducted to analyze electrical resistivity (R) and rheological properties (temperature, viscosity, height and lasting of the cushion) of different substances used in these techniques. Methods: Tested solutions were: 0.9% saline (S), platelet-rich plasma (PRP), Gliceol (GC), hyaluronic acid 2% (HA), Pluronic-F127 20% (PL), saline with 10% glucose (GS), Gelaspan (GP), Covergel-BiBio (TB) and PRP with TB (PRP+TB). Measurements of electrical and rheological properties were done at 0, 15, 30, 45 and 60 min after submucosal injection. Results: Solutions showed a wide variability of transepithelial R after submucosal injection. Substances able to maintain the highest R 60 min postinjection were TB (7 × 10 Ω), HA (7 × 10 Ω) and PL (7 × 10 Ω). Protective solutions against deep thermal injury (Tª lower than 60°C) were PL (47.6°C), TB (55°C) and HA (56.63°C). Shortest time to carry out resections were observed with GC (17.66″), PRP (20.3″) and GS (23.45″). Solutions with less cushion decrease (<25%) after 60 min were TB (11.74%), PL (18.63%) and PRP (22.12%). Conclusions: Covergel-BiBio, PL and HA were the best solutions with long-term protective effects (transepithelial R, lower thermal injury and less cushion decrease). Solutions with quicker resection time were GC, PRP and GS

Long-term outcome of patients wih distal ulcerative colitis and inflammation of the appendiceal orifice

Background & Aims: Skip inflammation of the appendiceal orifice has been described in distal UC (UC-IAO) but long-term clinical outcomes are poorly established. Our aim was to evaluate the long-term clinical outcomes of UC-IAO as compared to classic distal UC. Methods: Patients with UC-IAO were identified from the local IBD database. Disease outcome and therapeutic requirements during follow-up were accurately collected, and compared with a control group of patients with distal UC without periappendiceal involvement matched by disease extent (proctitis/distal), smoking habit, and date and age at diagnosis. Results: Fourteen UC patients were found to have UC-IAO, most of them with initial extent of UC limited to the rectum. All patients were initially managed with mesalazine administered orally (28.5%), topically (28.5%), or in combination (43%). After a median follow-up of 78 months (interquartile range - IQR 45-123) most UC-IAO patients were successfully managed with oral and/or topical aminosalycilates. Only one of them developed proximal disease progression. As compared to controls, no differences in clinical outcomes or therapeutic requirements were found. Conclusions: Patients with UC-IAO tend to present a mild course, with a low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy.CIBERehd of Fondo de Investigación Sanitaria of the Instituto de Salud Carlos III, from the Spanish Ministry of HealthMedicin

Crustacean and aquatic insect assemblages in the Mediterranean coastal ecosystems of Empord'a wetlands (NE Iberian peninsula)

Coastal wetlands are characterized by high biodiversity, which is one of the main criteria considered when establishing protection policies or when proposing adequate management actions. In this study, the crustacean and aquatic insect composition of the Empordà wetlands is described. These two faunal groups contribute highly to the total biodiversity in these wetlands but are seldom considered when managing natural areas. A selection (84 sampling points) of all water body types present in the Empord'a wetlands were sampled monthly (surber and dip net with a 250 μm mesh). Sampling was carried out during 3 surveys (1991-92, 1996-97 and 1999-2000). A rich fauna of 125 crustacean and 295 aquatic insect taxa was identified. We characterized each water body type using the most abundant species and the relative species richness of the taxonomic groups. A classification of the water body types, according to similarity between inventories, groups the brackish and hyperhaline systems in one cluster and the various freshwater systems in another one. Among freshwater systems, lotic waters and freshwater wetlands have a high similarity, whereas rice fields and freshwater springs have a low similarity.Los humedales costeros se caracterizan por una alta biodiversidad, que es uno de los principales criterios considerados al establecer políticas de protección o al proponer acciones de gestión adecuada. En este estudio se describe la composición de crustáceos e insectos acuáticos de los aiguamolls del Empordà. Estos dos grupos faunísticos contribuyen de forma importante al total de la biodiversidad en los humedales, pero raramente se tienen en consideración al gestionar las áreas naturales. Se muestreó mensualmente una selección (84 puntos de muestreo) de todas las tipologías de masas de agua presentes en los aiguamolls de l'Empordà mediante redes surber y salabres de poro de malla de 250 μm. El muestreo se llevó a cabo durante atres campañas (1991-92, 1996-97 y 1999-2000). Se identificó una riqueza faunística de 125 taxones de crustáceos y 295 taxones de insectos acuáticos. Cada tipología de masa de agua se caracterizó utilizando las especies más abundantes y la riqueza específica de los grupos faunísticos. La clasificación de las tipologías de masas de agua, según la similaridad entre inventarios faunísticos, agrupó los sistemas salobres y hiperhalinos en un grupo. Entre los sistemas de agua dulce, los sistemas lóticos y los humedales de agua dulce presentaron una alta similaridad, mientras que los arrozales y las surgencias de agua dulce mostraron una baja similaridad

Long-term Outcome of Patients with Distal ulcerative Colitis and Inflammation of the Appendiceal Orifice

Abstract Background &amp; Aims: Skip inflammation of the appendiceal orifice has been described in distal UC (UC-IAO) but long-term clinical outcomes are poorly established. Our aim was to evaluate the long-term clinical outcomes of UC-IAO as compared to classic distal UC. methods: Patients with UC-IAO were identified from the local IBD database. Disease outcome and therapeutic requirements during followup were accurately collected, and compared with a control group of patients with distal UC without periappendiceal involvement matched by disease extent (proctitis/distal), smoking habit, and date and age at diagnosis. Results: Fourteen UC patients were found to have UC-IAO, most of them with initial extent of UC limited to the rectum. All patients were initially managed with mesalazine administered orally (28.5%), topically (28.5%), or in combination (43%). After a median follow-up of 78 months (interquartile range -IQR 45-123) most UC-IAO patients were successfully managed with oral and/or topical aminosalycilates. Only one of them developed proximal disease progression. As compared to controls, no differences in clinical outcomes or therapeutic requirements were found. Conclusions: Patients with UC-IAO tend to present a mild course, with a low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio