First Molecular Diagnosis of Clinical Cases of Gastric Anisakiosis in Spain

Anisakiosis is a fish-borne disease with gastrointestinal and/or allergic symptoms caused by the consumption of raw or undercooked fish parasitized with nematode larvae of the genus Anisakis. In Europe, Anisakis pegre i has been detected as the causative agent, although the sibling species Anisakis simplex sensu stricto (s.s.) is also known to cause the disease in other parts of the world, and discrepancies exist regarding their respective pathogenic potential. In Spain a high number of cases has been recorded, with marinated anchovies being the main source of infection, although no specific diagnosis has been documented in humans. In this study, we analyzed three cases of anisakiosis in patients from Barcelona (Spain) who had consumed undercooked hake. All patients described epigastric pain and several larval nematodes were removed endoscopically from their stomachs. Larvae were morphologically characterized as third-stage larvae of Anisakis simplex sensu lato (s.l.) and molecularly identified as A. simplex (s.s.) by means of PCR RFLP of the ITS region of the rDNA and sequencing of the elongation factor1 alpha1 (EF1 -1) nDNA gen. This study represents the first specific identification of Anisakis larvae in clinical cases of anisakiosis reported in Spain. Specific molecular diagnosis is of crucial importance for assessing the health risk of Anisakis sibling species. Hake consu

Assessment of the level III of Inoue by preoperative endoscopic ultrasound and elastography: a novel approach to predict a periarterial divestment technique in borderline resectable (BR) or locally advanced (LA) pancreatic adenocarcinoma—How I do it

Pancreatic cancer; Periarterial divestment; Triangle operationCáncer de páncreas; Desinversión periarterial; Operación triangularCàncer de pàncrees; Desinversió periarterial; Operació triangularBackground Periarterial divestment is a surgical technique to approach borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) with arterial involvement. There are no reports in the literature regarding the role of endoscopic ultrasound and elastography (EUS-EG) in exploring the integrity of Inoue’s level III and its correlation with the periarterial divestment technique feasibility. Our research is aimed at exploring the role of EUS-EG in this scenario. Methods We describe our approach to Inoue’s level II by EUS-EG in patients with BR and LA pancreatic cancer patients after neoadjuvant chemotherapy. Results Between June 2019 and December 2020, four patients out of 25 were eligible to perform a preoperative EUS-EG. In all cases, Inoue’s level III integrity was corroborated by EUS-EG and confirmed posteriorly in the surgical scenario where a periarterial divestment technique was feasible. Vein resections were necessary in all cases, with no need for arterial resection. An R0 (> 1 mm) margin was achieved in all patients, and the histopathological assessment showed the presence of neurovascular tissue at the peripheral arterial margin. Conclusion Preoperatively, EUS-EG is a novel approach to explore the integrity of Inoue’s level III and could be helpful to preclude a periarterial divestment technique in borderline resectable or locally advanced pancreatic adenocarcinoma with arterial involvement.Open Access Funding provided by Universitat Autonoma de Barcelona

Adult-specific Reelin expression alters striatal neuronal organization: implications for neuropsychiatric disorders

In addition to neuronal migration, brain development, and adult plasticity, the extracellular matrix protein Reelin has been extensively implicated in human psychiatric disorders such as schizophrenia, bipolar disorder, and autism spectrum disorder. Moreover, heterozygous reeler mice exhibit features reminiscent of these disorders, while overexpression of Reelin protects against its manifestation. However, how Reelin influences the structure and circuits of the striatal complex, a key region for the above-mentioned disorders, is far from being understood, especially when altered Reelin expression levels are found at adult stages. In the present study, we took advantage of complementary conditional gain- and loss-of-function mouse models to investigate how Reelin levels may modify adult brain striatal structure and neuronal composition. Using immunohistochemical techniques, we determined that Reelin does not seem to influence the striatal patch and matrix organization (studied by μ-opioid receptor immunohistochemistry) nor the density of medium spiny neurons (MSNs, studied with DARPP-32). We show that overexpression of Reelin leads to increased numbers of striatal parvalbumin- and cholinergic-interneurons, and to a slight increase in tyrosine hydroxylase-positive projections. We conclude that increased Reelin levels might modulate the numbers of striatal interneurons and the density of the nigrostriatal dopaminergic projections, suggesting that these changes may be involved in the protection of Reelin against neuropsychiatric disorders

Perdent el fil de la crítica. La crítica de teatre en l'arribada a l'era digital (2011-2020)

En el present estudi elaborem un panorama de la crítica teatral publicada als mitjans entre 2011 i 2020 a Barcelona, observant-ne aspectes generals com la freqüència de publicació o les condicions laborals dels crítics. Seguidament aprofundim en els textos a partir d'un cas concret: les crítiques publicades a propòsit de l'estrena d'Islàndia de Lluïsa Cunillé al TNC (2017). Concloem que la crítica teatral en paper, tot i estar pràcticament en perill d'extinció, constitueix el gruix de crítica professional i raonada, mentre que la crítica que prolifera a internet és des-professionalitzada i no aconsegueix cap estil consolidat de crítica argumentada

Utilitat de l'elastografia mitjançant l'ecoendoscòpia en el diagnòstic de la pancreatitis crònica

INTRODUCCIÓ: L'ecoendoscòpia (EUS) és una tècnica útil en el diagnòstic de PC perquè ens permet identificar els canvis parenquimatosos i ductals del pàncrees. Els criteris de Rosemont s'han proposat per a establir els diferents graus de PC mitjançant EUS. L'elastografia mitjançant EUS (EUS-EG) és una prova d'imatge que ens permet establir diferències de duresa o rigidesa entre el teixit malalt i el teixit normal. Per arribar al diagnòstic final de PC el patró de referència és la histologia. HIPÒTESI: La hipòtesi que s'ha proposat en aquest estudi és que la informació obtinguda mitjançant EUS-EG és útil per al diagnòstic i classificació de la PC. OBJECTIUS: Avaluar l'eficàcia de la EUS-EG qualitativa i la EUS-EG quantitativa com tests diagnòstics i classificatoris per a la PC. MÈTODE: Es va dissenyar un estudi retrospectiu i unicèntric a l'Hospital Universitari Vall d'Hebron de Barcelona per avaluar el diagnòstic i estadificació de la PC mitjançant EUS i EUS-EG qualitativa i quantitativa. RESULTATS: es van incloure 163 pacients que van consultar per a la realització d'una EUS diagnòstica al servei d'endoscòpies de l'Hospital Universitari Vall d'Hebron de Barcelona. Al realitzar la EUS-EG qualitativa el patró heterogeni va ser el més freqüent, trobant-se en 116 pacients (71%). El patró homogeni va ser predominant en el grau 1 (pàncrees normal). En canvi, el patró heterogeni va ser el més freqüent en els graus 2, 3 i 4 observant-se en el 88%, 100% i 97% dels pacients, respectivament. Al comparar la distribució dels patrons obtinguts en els diferents graus, es van trobar diferències significatives entre el grau 1 i la resta de graus (p <0.0001). A partir d'aquests resultats concloem que la EUS-EG qualitativa és un bon test diagnòstic per a la PC. Un patró heterogeni diagnostica la PC amb una S 94%, E 75%, VPP 89% i VPN 85%. La EUS-EG qualitativa discrimina clarament entre pàncrees normal i la resta de grups però no entre els diferents graus de consistent, suggestiu i indeterminat per a PC. El patró heterogeni oferia una S del 98% i E 45% per detectar pacients amb pàncrees suggestiu o consistent amb PC i una S del 97% i E del 35% per detectar pacients amb pàncrees consistent amb PC. La relació de deformació o ""strain ràtio"" (SR) és la mesura d'avaluació de la variable EUS-EG quantitativa. Al realitzar la EUS-EG quantitativa en els graus 1, 2, 3 i 4 la xifra va ser de 2.8, 3.7, 4.8 i 5.1 respectivament. Al comparar els resultats entre els diferents graus es van observar diferències significatives entre els 4 graus (p <0.001 p <0.003) llevat al comparar grau 3 amb grau 4 que la p = 0.89. Al comparar el SR entre els diferents graus el SR sempre va ser menor en els graus inferiors. En totes les comparacions realitzades es va apreciar una diferència estadísticament significativa (p <0.0001). A partir de la informació EUS-EG quantitativa obtinguda en els diferents grups de pacients segons la classificació de Rosemont i a mesura que la fibrosi pancreàtica augmenta a la PC, aquests grups podrien correspondre a diferents estadis de la malaltia. En l'anàlisi binari no aconseguim establir aquesta correlació. Una raó de tensió igual o superior a 3.08 amb una sensibilitat 80% i especificitat de 81% i un VPP 90% és indicativa de PC, sense poder diferenciar indeterminada, suggerent o diagnòstica. CONCLUSIONS: La EUS-EG tant qualitativa com quantitativa permet discriminar entre un pàncrees normal i una pancreatitis crònica però no permet distingir entre els diferents graus de pancreatitis crònica.INTRODUCCIÓN: La ecoendoscopia (EUS) es una técnica útil en el diagnóstico de PC porque nos permite identificar los cambios parenquimatosos y ductales del páncreas. Los criterios de Rosemont se han propuesto para establecer los diferentes grados de PC mediante EUS. La elastografía mediante EUS (EUS-EG) es una nueva prueba de imagen que nos permite establecer diferencias de dureza o rigidez entre el tejido enfermo y el tejido normal. Para llegar al diagnóstico final de PC el patrón de referencia es la histología. HIPÓTESIS: La hipótesis que se ha propuesto en este estudio es que la información obtenida mediante EUS-EG es útil para el diagnóstico y clasificación de la PC. OBJETIVOS: Evaluar la eficacia de la EUS-EG cualitativa y la EUS-EG cuantitativa como tests diagnósticos y clasificatorios para la PC. MÉTODO: Se diseñó un estudio retrospectivo y unicéntrico en el Hospital Universitari Vall Hebron de Barcelona para evaluar el diagnóstico y estadificación de PC mediante EUS y EUS-EG cualitativa y cuantitativa. RESULTADOS: se incluyeron 163 pacientes que consultaron para la realización de una EUS diagnóstica al servicio de endoscopias del Hospital Vall Hebron de Barcelona. Al realizar la EUS-EG cualitativa el patrón heterogéneo fue el más frecuente, encontrándose en 116 pacientes (71%). El patrón homogéneo fue predominante en el grado 1 ( páncreas normal). En cambio, el patrón heterogéneo fue el más frecuente en los grados 2, 3 y 4 observándose en el 88%, 100% y 97% de los pacientes, respectivamente. Al comparar la distribución de los patrones obtenidos en los diferentes grados, se encontraron diferencias significativas entre el grado 1 y el resto de grados. A partir de estos resultados concluimos que la EUS-EG cualitativa es un buen test diagnóstico para la PC. Un patrón heterogéneo diagnostica la PC con una S 94%, E 75%, VPP 89% y VPN 85%. La EUS-EG cualitativa discrimina claramente entre páncreas normal y el resto de grupos pero no entre los diferentes grados de consistente, sugerente e indeterminado para PC. El patrón heterogéneo ofrecía una S del 98% y E 45% para detectar pacientes con páncreas sugestivo o consistente con PC y una S del 97% y E del 35% para detectar pacientes con páncreas consistente con PC. La relación de deformación o "strain ratio" (SR) es la medida de evaluación de la variable EUS-EG cuantitativa. Al realizar la EUS-EG cuantitativa en los grado 1, 2, 3 y 4 la cifra fue de 2.8, 3.7, 4.8 y 5.1 respectivamente. Al comparar los resultados entre los diferentes grados se observaron diferencias significativas entre los 4 grados ( p < 0.001 y p < 0.003 ) salvo al comparar grado 3 con grado 4 que la p = 0.89. Al comparar el SR entre los diferentes grados el SR siempre fue menor en los grados inferiores. En todas las comparaciones realizadas se apreció una diferencia estadísticamente significativa. A partir de la información EUS-EG cuantitativa obtenida en los diferentes grupos de pacientes según la clasificación de Rosemont y a medida que la fibrosis pancreática aumenta en la PC, estos grupos podrían corresponder a diferentes estadios de la enfermedad. En el análisis binario no logramos establecer esta correlación. Una razón de tensión igual o superior a 3.08 con una sensibilidad 80% y especificidad de 81% y un VPP 90% es indicativa de PC, sin poder diferenciar indeterminada, sugerente o diagnóstica. CONCLUSIONES: La EUS-EG tanto cualitativa como cuantitativa permite discriminar entre un páncreas normal y una pancreatitis crónica pero no permite distinguir entre los diferentes grados de pancreatitis crónica.INTRODUCTION: Endoscopic ultrasound (EUS) is a useful technique in the diagnosis of CP because it allows us to identify parenchymal and ductal changes in the pancreas. The Rosemont criteria have been proposed to establish the different degrees of CP by EUS. EUS elastography (EUS-EG) is a new imaging test that allows us to establish differences in tissue stiffness between diseased tissue and normal tissue. To reach the final diagnosis of CP, the reference pattern is histology. HYPOTHESIS: The hypothesis that has been proposed in this study is that the information obtained through EUS-EG is useful for the diagnosis and classification of CP. OBJECTIVES: To evaluate the efficacy of qualitative EUS-EG and quantitative EUS-EG as diagnostic and classificatory tests for CP. METHOD: A retrospective and single-center study was designed at the Hospital Vall Hebron in Barcelona to evaluate the diagnosis and staging of CP using EUS and qualitative and quantitative EUS-EG. RESULTS: 163 patients were included who consulted for a diagnostic EUS at the endoscopy service of the Vall d'Hebron University Hospital in Barcelona. When performing the qualitative EUS-EG, the heterogeneous pattern was the most frequent, found in 116 patients (71%). The homogeneous pattern was predominant in grade 1 (normal pancreas). On the other hand, the heterogeneous pattern was the most frequent in grades 2, 3 and 4, observed in 88%, 100% and 97% of the patients, respectively. When comparing the distribution of the patterns obtained in the different grades, significant differences were found between grade 1 and the rest of grades (p <0.0001), From these results we conclude that qualitative EUS-EG is a good diagnostic test for CP. A heterogeneous pattern diagnoses CP with an S 94%, E 75%, PPV 89%, and NPV 85%. The qualitative EUS-EG clearly discriminates between normal pancreas and the rest of the groups, but not between the different degrees of consistent, suggestive and indeterminate for CP. The heterogeneous pattern offered a S 98% and E 45% to detect patients with a pancreas suggestive or consistent with CP and a S of 97% and E of 35% to detect patients with a pancreas consistent with CP. The deformation ratio or "strain ratio" (SR) is the evaluation measure of the quantitative EUS-EG. When performing the quantitative EUS-EG in grades 1, 2, 3 and 4, the result was 2.8, 3.7, 4.8 and 5.1 respectively. When comparing the results between the different grades, significant differences were observed between the four grades (p <0.001 and p <0.003) except when comparing grade 3 with grade 4 that p = 0.89. When comparing the SR between the different grades, the SR was always lower in the lower grades. In all the comparisons made, a statistically significant difference (p <0.0001) was observed. Based on the quantitative EUS-EG information obtained in the different groups of patients according to the Rosemont classification and as pancreatic fibrosis increases in CP, these groups could correspond to different stages of the disease. In binary analysis we were unable to establish this correlation. A strain ratio equal to or greater than 3.08 with a sensitivity of 80% and specificity of 81% and a PPV of 90% is indicative of CP, without being able to differentiate indeterminate, suggestive or diagnostic. CONCLUSIONS: Qualitative and quantitative EUS-EG makes it possible to discriminate between a normal pancreas and chronic pancreatitis, but does not make it possible to distinguish between the different degrees of chronic pancreatitis

Assessment of the level III of Inoue by preoperative endoscopic ultrasound and elastography : a novel approach to predict a periarterial divestment technique in borderline resectable (BR) or locally advanced (LA) pancreatic adenocarcinoma-How I do it

Altres ajuts: acords transformatius de la UABBackground: Periarterial divestment is a surgical technique to approach borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) with arterial involvement. There are no reports in the literature regarding the role of endoscopic ultrasound and elastography (EUS-EG) in exploring the integrity of Inoue's level III and its correlation with the periarterial divestment technique feasibility. Our research is aimed at exploring the role of EUS-EG in this scenario. Methods: We describe our approach to Inoue's level II by EUS-EG in patients with BR and LA pancreatic cancer patients after neoadjuvant chemotherapy. Results: Between June 2019 and December 2020, four patients out of 25 were eligible to perform a preoperative EUS-EG. In all cases, Inoue's level III integrity was corroborated by EUS-EG and confirmed posteriorly in the surgical scenario where a periarterial divestment technique was feasible. Vein resections were necessary in all cases, with no need for arterial resection. An R0 (> 1 mm) margin was achieved in all patients, and the histopathological assessment showed the presence of neurovascular tissue at the peripheral arterial margin. Conclusion: Preoperatively, EUS-EG is a novel approach to explore the integrity of Inoue's level III and could be helpful to preclude a periarterial divestment technique in borderline resectable or locally advanced pancreatic adenocarcinoma with arterial involvement

Adult-specific Reelin expression alters striatal neuronal organization : implications for neuropsychiatric disorders

In addition to neuronal migration, brain development, and adult plasticity, the extracellular matrix protein Reelin has been extensively implicated in human psychiatric disorders such as schizophrenia, bipolar disorder, and autism spectrum disorder. Moreover, heterozygous reeler mice exhibit features reminiscent of these disorders, while overexpression of Reelin protects against its manifestation. However, how Reelin influences the structure and circuits of the striatal complex, a key region for the above-mentioned disorders, is far from being understood, especially when altered Reelin expression levels are found at adult stages. In the present study, we took advantage of complementary conditional gain- and loss-of-function mouse models to investigate how Reelin levels may modify adult brain striatal structure and neuronal composition. Using immunohistochemical techniques, we determined that Reelin does not seem to influence the striatal patch and matrix organization (studied by μ-opioid receptor immunohistochemistry) nor the density of medium spiny neurons (MSNs, studied with DARPP-32). We show that overexpression of Reelin leads to increased numbers of striatal parvalbumin- and cholinergic-interneurons, and to a slight increase in tyrosine hydroxylase-positive projections. We conclude that increased Reelin levels might modulate the numbers of striatal interneurons and the density of the nigrostriatal dopaminergic projections, suggesting that these changes may be involved in the protection of Reelin against neuropsychiatric disorders