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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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    Exploring glucocorticoid receptor signalling in lymphangioleiomyomatosis
    (European Respiratory Society, 2026-06-29) Baiges, Alexandra; Ruiz Auladell, Lara; García, Irene; Rigo Bonnin, Raúl; Tang, Yan; Bou-Farhat, Elias J.; Espín, Roderic; Sanz, Rosario T.; Vicent, Guillermo Pablo; Donate-Castillo, Mercè; Shabbir, Arzoo; Adams Furmanski, Jonathan; Herranz Ors, Carmen; Laporta, Rosalía; Salas Antón, Clara; Ussetti, Piedad; Valenzuela-Pascual, Clàudia; Ancochea, Julio; Rodríguez-Portal, José Antonio; Molina Molina, María; Casanova, Álvaro; Revilla López, Eva; Gómez Carrera, Luis; Matias-Guiu, Xavier, 1958-; Pavón, Miquel Ángel; Jung, Dominik; Bachmann, Hagen S.; Lago Lestón, Ramón M.; Muinelo Romay, Laura; Farré, Xavier; Cid, Rafael de; Leung, Calvin S.; Zannas, Anthony S.; Esteller, Manel; Sellarés Torres, Jacobo; Błasińska, Katarzyna; Róży, Adriana; Skrońska, Paulina; Gómez, Antonio; Holz, Marina K.; Di Martino, Julie S.; Monk, David; Sefton, Charlotte; Walker, Leanne; White, Anne; Clements, Debbie; Miller, Suzanne; Johnson, Simon R.; Hunt, Hazel J.; Henske, Elizabeth P.; Kwiatkowski, David; Radzikowska, Elżbieta; Mateo González, Francesca; Pujana Genestar, M. Ángel
    Background: Lymphangioleiomyomatosis (LAM) is a rare, low-grade neoplasm that causes progressive cystic lung destruction and is often associated with renal angiomyolipomas (AMLs). Given evidence of pleiotropy linking LAM risk to pulmonary traits, we investigated whether glucocorticoid receptor (GR) signalling might influence LAM biology and clinical features. Methods: We combined cell-based studies, GR inhibition/activation assays, gene expression and single-cell RNA sequencing analyses, and hormone profiling in retrospective and prospective LAM cohorts. Cellular experiments employed murine Tsc2−/− embryonic fibroblasts and human TSC2−/− AML cells. Circulating steroid levels were measured in women with LAM and healthy controls, and associations with clinical variables were evaluated. Results: In LAM/AML models, GR activation by glucocorticoids elicited transcriptional responses, whereas GR inhibition reduced clonogenic potential. GR stimulation was associated with CDKN1C upregulation through enhancer binding, and single-cell profiling suggested a shift towards slower proliferation and differentiation-prone states enriched for a LAM cell signature. Clinically, our analyses suggest that women with LAM may show altered circulating hormone profiles, including elevated adrenocorticotropic hormone (ACTH) and cortisol levels, together with reduced 17-hydroxyprogesterone, compared with controls. In a prospective cohort, ACTH levels were suggestively associated with advanced radiological disease stage. AML cells showed elevated expression of POMC, which encodes the precursor of ACTH, and POMC peptide was detected in LAM lung tissue. Conclusions: Our findings suggest that GR signalling may contribute to aspects of LAM cell behaviour and disease status. Further investigation of this pathway could clarify its role as a disease modifier and potential therapeutic target.
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    Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Low Rectal Cancers-Reply.
    (American Medical Association (AMA), 2021-02-01) Biondo, Sebastián; Trenti, Loris; Kreisler, Esther
    We thank the authors for their comments on our article. We discuss the points highlighted in the letters. Regarding technique and homogeneity of the groups, we stress that only patients with rectal cancer who are candidates for ultralow anterior rectal resection with sphincter preservation and hand-sewn coloanal anastomosis (CAA) were considered for inclusion. Indicating an intersphincteric resection does not depend on the chosen anastomosis but on the lower distance of the tumor from the anal canal. This scenario was homogeneous between groups. Therefore, neither radiotherapy nor intersphincteric approach or characteristics of the rectal dissection were confounding issues. Vascular ligation, restricted to inferior mesenteric artery, splenic flexure mobilization, and mesorectum dissection did not differ depending on the type of anastomosis. Ischemia cannot be attributed to technical differences between anastomotic techniques. We no longer perform a pouch technique after the evidence of long-term scarce benefits.
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    The WID-EC test for the detection and risk prediction of endometrial cancer
    (BioMed Central, 2023-05-01) Barrett, James E; Jones, Allison; Evans, Iona; Herzog, Chiara; Reisel, Daniel; Olaitan, Adeola; Mould, Tim; MacDonald, Nicola; Doufekas, Konstantinos; Newton, Claire; Crosbie, Emma J.; Bjørge, Line; Colombo, Nicoletta; Dostalek, Lukas; Costas, Laura; Peremiquel Trillas, Paula; Ponce Sebastià, Jordi; Matias-Guiu, Xavier, 1958-; Zikan, Michal; Cibula, David; Wang, Jiangrong; Sundström, Karin; Dillner, Joakim; Widschwendter, Martin
    The incidence of endometrial cancer is rising. Measures to identify women at risk and to detect endometrial cancer earlier are required to reduce the morbidity triggered by the aggressive treatment required for advanced endometrial cancer. We developed the WID-EC (Women's cancer risk IDentification-Endometrial Cancer) test, which is based on DNA methylation at 500 CpG sites, in a discovery set of cervical liquid-based cytology samples from 1086 women with and without an endometrial cancer (217 cancer cases and 869 healthy controls) with a worse prognosis (grade 3 or ≥stage IB). We validated the WID-EC test in an independent external validation set of 64 endometrial cancer cases and 225 controls. We further validated the test in 150 healthy women (prospective set) who provided a cervical sample as part of the routine Swedish cervical screening programme, 54 of whom developed endometrial cancer within 3 years of sample collection. The WID-EC test identified women with endometrial cancer with a receiver operator characteristic area under the curve (AUC) of 0.92 (95% CI: 0.88-0.97) in the external set and of 0.82 (95% CI: 0.74-0.89) in the prospective validation set. Using an optimal cutoff, cancer cases were detected with a sensitivity of 86% and a specificity of 90% in the external validation set, and a sensitivity and specificity of 52% and 98% respectively in the prospective validation set. The WID-EC test can identify women with or at risk of endometrial cancer.
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    The Evolving Role of Taxanes in Combination With Cetuximab for the Treatment of Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck: Evidence, Advantages, and Future Directions
    (Frontiers Media, 2019-08-21) Guigay, Joël; Tahara, Makoto; Licitra, Lisa; Keilholz, Ulrich; Friesland, Signe; Witzler, Pauline; Mesía Nin, Ricard
    The addition of cetuximab to platinum-based chemotherapy (cisplatin or carboplatin plus 5-fluorouracil [5-FU]), followed by maintenance cetuximab until disease progression (EXTREME), resulted in the first regimen to yield significantly improved survival outcomes in the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) in over 30 years. Currently, the EXTREME regimen is a guideline-recommended treatment in the first-line R/M setting, and, therefore, it is used as a control arm in all new first-line, phase 3 immunotherapy trials. More recently, new checkpoint inhibitor approaches have emerged and are changing the treatment landscape for PD-L1-positive patients with R/M SCCHN. Additionally, alternative chemotherapy backbones in R/M SCCHN are continually investigated. Replacing 5-FU with a taxane in the EXTREME regimen seeks to take advantage of the potential immunogenic and proapoptotic synergy between cetuximab and docetaxel or paclitaxel. These cetuximab-, platinum-, and taxane-based treatments have demonstrated promising survival results and cytoreductive properties in single-arm studies. Thus, these combination treatments may be of importance to patients with high tumor burden and dangerous site involvements (e.g., causing bleeding, suffocation, dysphagia, or ulceration), in whom symptom relief is a key treatment goal. TPExtreme is the first large, randomized trial comparing a cetuximab, platinum, and taxane combination regimen with EXTREME. Currently, the substitution of 5-FU with a taxane is a feasible and clinically beneficial option for patients with contraindications to 5-FU. The TPEx regimen appears to be a new option in first-line R/M SCCHN, with a shorter time on CT and significantly lower toxicity than the EXTREME regimen. For patients with R/M disease in whom further cisplatin- or carboplatin-based treatment is unsuitable, or whose disease has already progressed on first-line R/M therapy, treatment options such as cetuximab plus a taxane, which capitalize on the combinative ability of the 2 agents, can be considered. Notably, it is as of yet unknown what second-line treatments may be suitable to follow a checkpoint inhibitor-based first-line therapy. Keywords: B490; EXTREME; R/M SCCHN; TPEx; cetuximab; docetaxel; paclitaxel.
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    Characterizing Aeromonas spp. as a Potential Sentinel Organism for Antimicrobial Resistance Dissemination in Wastewater and Drinking Water Treatment Systems: A Case Study in the Barcelona Metropolitan Area, Spain
    (MDPI, 2026-03-01) Mondéjar, Laura; Gabasa, Yaiza; Castellsagués, Laura; Vilaró, Carles; Galofre, Belén; González-Díaz, Aida; Martí Martí, Sara; Sanz, Sergi; Soto González, Sara M.; Ballén, Victoria; Pinar-Méndez, Anna
    Background: Wastewater treatment plants (WWTPs) are hotspots of antimicrobial resistance (AMR) due to inputs from diverse anthropogenic sources. Aeromonas spp., ubiquitous in aquatic environments, often carry clinically relevant antibiotic resistance genes (ARGs) and can persist beyond fecal contamination indicators, making them promising sentinel organisms for AMR dissemination. The aim of this study was to assess the suitability of Aeromonas spp. in this role by characterizing resistance profiles, associated virulence factor genes (VFGs), genetic mobility, and persistence across wastewater and drinking water treatment processes in the Barcelona metropolitan area, Spain. Methods: Isolates were phenotypically characterized and screened for ARGs, VFGs, integrons, and heavy metal tolerance genes, followed by whole-genome sequencing (WGS). Biofilm formation was assessed in vitro. Conjugation assays with Escherichia coli evaluated horizontal gene transfer (HGT) potential. Results: A total of 428 antibiotic-resistant Aeromonas spp., the most abundant antibiotic-resistant bacteria isolated during the 2023 sampling campaigns from two WWTPs and one drinking water treatment plant (DWTP), were characterized. Trimethoprim/sulfamethoxazole (SXT) non-susceptibility was most frequent (72%), followed by cefoxitin resistance (65.4%). The sul1 (57.5%) and blaMOX (78.6%) genes predominated among SXT- and β-lactam-resistant isolates. The merA gene was detected in 23.6%; 97.9% harbored at least one VFG (aerA, act, fla, alt, or hlyA), and 70.3% carried intI1. Half formed biofilm. Conjugation confirmed bi-directional HGT, and WGS revealed persistent ST3458 clones across treatment stages. Conclusions: WWTPs and DWTPs act as reservoirs of antibiotic-resistant Aeromonas spp., demonstrating persistence and HGT potential. Findings support their use as sentinel organisms for AMR surveillance in aquatic environments and for assessing treatment efficacy, highlighting variability across treatment types and locations, and reinforcing their relevance for urban water reclamation monitoring. Keywords: Aeromonas spp.; antimicrobial resistance; antibiotic resistance genes; wastewater treatment plants; drinking water treatment; horizontal gene transfer; biofilms; environmental surveillance
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    Rapid identification of a Serratia marcescens outbreak in a neonatal intensive care unit by third-generation long-read nanopore sequencing
    (BioMed Central, 2025-06-04) Henares, Desiree; Cubero, Meritxell; Martínez de Albéniz, Irene; Arranz Betegón, Angela; Rocafort, Mercedes; Brotons, Pedro; Perez-Argüello Amaresh; Troyano Maria José; Gené, Amadeu; Lluansí, Aleix; Iriondo Sanz, Martín; Jordán García, Iolanda; Fortuny, Clàudia; Urrea, Mireia; Muñoz Almagro, Carmen
    Background Serratia marcescens is a frequent cause of outbreaks in high-risk hospital settings such as neonatal intensive care units (NICU). This study investigated a potential S. marcescens outbreak in the NICU of a reference children’s hospital using Whole Genome Sequencing (WGS). Additionally, it assessed the performance of third-generation sequencing for the rapid and accurate identification and characterization of the outbreak’s clonal strain. Methods A prospective study was conducted from September 8th to November 12th 2021, following a sharp increase in invasive S. marcescens infections in the NICU of University Children’s Hospital Sant Joan de Déu (Barcelona, Spain). This study included all patients admitted to NICU and other hospital wards from whom S. marcescens was isolated in any sample type. Nanopore sequencing was performed on S. marcescens isolates. Genomic characterization included phylogenetic analyses and detection of antimicrobial resistance genes. Results Twenty-nine patients (16 NICU and 13 non-NICU patients) infected/colonized by S. marcescens were detected during the study period, accounting for a total of 61 isolates. The genomic characterization was performed on 24 isolates from 14 NICU-patients and 10 isolates from eight non-NICU patients. Phylogenetic analyses evidenced three clusters of closely related strains; cluster I (n = 22), II (n = 2) and III (n = 5). The remaining isolates (n = 5) did not cluster. Cluster I contained most isolates from NICU patients (20/24), and most isolates from NICU-patients with confirmed invasive disease (7/8). Cluster II contained two isolates from two NICU-patients, one presenting with invasive disease. The resistance gene blaSRT was found in 97% of S. marcescens isolates (33/34). All isolates exhibited the amikacin-tobramycin aac(6’) resistance gene and three multi-drug efflux pumps genes; sdeY, sdeB and smfY. The tetracycline tet(41) resistance gene was found in non-clustered isolates (4/34). The first results were available less than one month after the outbreak’s alarm, and complete genomic study after two months. Conclusion Two clonal strains were co-circulating in the NICU setting, with one being the major strain responsible for the outbreak. Rapid molecular characterization with nanopore sequencing confirmed the outbreak. It revealed the phylogenetic relationships among isolates and their antimicrobial potential. This approach enabled effective contextualization of the outbreak and allowed for monitoring its progression.
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    Artificial intelligence in thoracic surgery consultations: evaluating the concordance between a large language model and expert clinical decisions
    (Frontiers Media, 2025-11-17) Déniz Armengol, Carlos; Marcè, Judith; Macía, Ivan; Rivas Doyague, Francisco; Muñoz, Ana; Paradela, Marina; García, Sonia; Moreno, Camilo; Serratosa, Inés; García, Marta; Rodríguez-Martos, Tania; Ojanguren, Amaia
    Background: Artificial intelligence (AI) and large language models (LLMs) are increasingly used in clinical workflows, but their real-world application in thoracic surgery decision-making remains underexplored. Methods: This retrospective observational study assessed the concordance between diagnostic and therapeutic recommendations generated by Scholar GPT (based on GPT-4) and decisions made by board-certified thoracic surgeons. All outpatient consultations over one week in a tertiary care hospital were included. Each case was evaluated using a 6-point concordance scale (0–5), developed to quantify agreement in diagnosis and treatment planning. This was a retrospective observational, single-centre analysis; two independent thoracic surgeons assigned the concordance score. We report descriptive statistics and used t-tests/ANOVA for continuous variables and chi-square tests for categorical variables. Given the exploratory design, no a priori sample-size calculation or power analysis was performed. Results: A total of 81 consultations were analysed. The mean concordance score was 3.67 ± 1.17. High concordance (scores 4–5) occurred in 56.8% of cases, particularly in oncological diagnoses such as mediastinal and pleural tumours. Lower concordance was observed in complex or functional conditions like metastatic lung disease and thoracic outlet syndrome. No significant differences were found between consultation modalities or visit types. Conclusion: Scholar GPT demonstrated promising alignment with surgeon decisions in structured oncologic cases but showed variability in complex scenarios. While AI may assist in streamlining outpatient workflows, its use should remain complementary to expert clinical judgment. These findings are exploratory and should be interpreted with caution given the small sample size and single-centre, one-week design.
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    Impaired expression of ecto-nucleotidases in human endometrial pathologies
    (Sercrisma International, 2019-09-09) Martín Satué, Mireia; Matias-Guiu, Xavier, 1958-; Rodríguez-Martínez, Aitor; Trapero Candela, Carla; Vidal, August; Gómez de Aranda, Immaculada; Fernandez-Montolí, M.A.; Piulats, Josep M.; Coroleu, Buenaventura; Barri, Pere; Tresserra, Francesc; Ponce Sebastià, Jordi
    The levels of extracellular ATP and its derivatives such as adenosine are impaired in the tissue microenvironment during tissue stress conditions such as hypoxia, infection, metabolic stress, tumor transformation and inflammation. Ecto-nucleotidases are the main regulators of extracellular ATP and adenosine levels. The aim of the present work is to upgrade our understanding of the role and location of ecto-nucleotidases in the context of two endometrial pathologies: cancer and endometriosis, as well as to investigate new diagnostic and treatment modalities based on the inhibition of ecto-nucleotidases' activities. We have analyzed by means of immunolabeling and in situ enzyme histochemistry human endometrial samples from: 1) endometrial tumors, and, 2) eutopic endometria as well as ectòpic endometriotic lesions from women with endometriosis. We have also studied endometrial cell cultures to evaluate the consequences of the overexpression of ecto-nucleotidases in their proliferative and invasive phenotypes. Ecto-nucleotidases showed impaired expression in pathological conditions when compared with non-pathological endometria. This altered pattern includes changes in expression levels and changes in protein localization, mainly a switch between epithelium and stroma. Overexpression of ecto-nucleotidases in endometrial cell cultures lead to changes in the proliferation and invasion rates. Impaired ecto-nucleotidases activities in endometrium might contribute to the pathogenesis and maintenance of endometrial pathologies with an inflammatory component such as cancer and endometriosis.
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    New method to simultaneously characterize the expression and in situ activity of ecto-nucleotidase in human tissues
    (Sercrisma International, 2017) Villamonte-Román, María; Torrejón-Escribano, Benjamín; Vidal-Bel, August; Ponce Sebastià, Jordi; Matias-Guiu, Xavier, 1958-; Martín Satué, Mireia
    Introduction: Extracellular nucleotides, such as ATP, and nucleosides, such as adenosine, act as autocrine and paracrine molecules that have multiple roles in virtually all organs and tissues, including female reproductive organs. Extracellular ATP and adenosine levels are regulated by the action of ecto-nucleotidases that hydrolyse ATP to adenosine. The aim of the present study was to set up a new method to simultaneously localize the cellular distribution and in situ activity of ecto-nucleotidases in tissue sections. We used this method to characterize the expression of ecto-nucleotidases in human oviducts. Material and Methods: Cryosections of non-pathological human oviducts were obtained from salpingectomy at the Service of Gynecology of Bellvitge Hospital. Samples were incubated with the following primary antibodies against human enzymes: anti-nucleoside triphosphate diphosphohydrolase 1 (NTPDase1/CD39), anti-NTPDase2, and anti-placental alkaline phosphatase (PLAP). In situ activity reactions were performed on the same slides using the Wachstein/Meisel lead phosphate method with ATP or ADP as substrate. For alkaline phosphatase activity, the BCIP/NBT revealing reagent was used. The sections were then incubated with the appropriate Alexa Fluor-conjugated secondary antibodies and mounted with Prolong Gold antifade with DAPI medium. Results: NTPDase1 was expressed in the smooth muscle and endothelial cells, coinciding with localization of ADPase activity. NTPDase2 was largely expressed and active (ATPase activity) in ciliated cells and in connective tissue. PLAP was immunodetected and active in luminal epithelium. Conclusions: We found that this new method is specific, sensitive, and useful with diferent tissues. Our results show that ecto-nucleotidases are abundantly present in human oviducts where these enzymes work in concert to metabolize extracellular ATP to adenosine. This study contributes to knowledge of purinergic signaling by ecto-nucleotidases in the female reproductive system.
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    Ecto-nucleotidase expression and activity in endometrioid-type endometrial carcinoma cell lines
    (Sercrisma International, 2017-09-08) Rodríguez-Martínez, Aitor; Matias-Guiu, Xavier, 1958-; Martín Satué, Mireia
    Introduction: ATP and adenosine are known for their role in promoting an immunosuppressive environment at the tumor site. It is known that some ecto-nucleotidases, proteins that handle the hydrolysis of tri-, di- and monophosphate nucleotides, are overexpressed in endometrial tumor tissues although the mechanisms underlying these processes remain controversial. In the present study we characterized, with cytochemistry and i mmunofluorescence, the ecto-nucleotidase profiles in endometrioid-type endometrial carcinoma cell lines. Furthermore, we have developed a new approach capable of simultaneously detecting both alkaline phosphatase expression and activity. Materials and methods: Cell lines: 3 endometrioid endometrial carcinoma cell lines (Ishikawa, HEC-1B and ECC-1) were used for cytochemistry and immunofluorescence experiments. In situ ecto-nucleotidase enzyme activities: ATPase, ADPase, and AMPase activity experiments were performed in all cell lines, based on the Wachstein/Meisel technique. Immunofluorescence experiments: cell immunolabeling was performed using primary antibodies against different members of the ecto-nucleotidases: anti-ectonucleoside triphosphate diphosphohydrolase 2 (E-NTPDase2), anti-E-NTPDase3, anti-CD73, and anti-placental-like alkaline phosphatase (PLAP). Alkaline phosphatase immunoactivity assay: for the detection of both activity and al kaline phosphatase expression we developed a combinatorial assay in which enzyme activity can be co-visualized with protein expression. Immunofluorescence followed by an activity assay was performed on AP-expressing cells. Results: Cytochemistry enzyme assays showed moderate ATPase activity in both Ishikawa and ECC-1 cell lines. Moderate ADPase activity was found in ECC-1 cells and high AMPase activity was detected in HEC-1B cells. In immunolabeling experiments we found NTPDase2 protein expression in all three cell lines, with NTPDase3 expression restricted to ECC-1 cells. CD73 was detected in all three cell lines. Moderate alkaline phosphatase activity and protein expression were found in Ishikawa and ECC-1 cells. A wide differential range of activities and ecto-nucleotidase expression among the studied cell lines was observed. NTPDase2 and NTPDase3 expression correlated with ATPase activity. CD73 protein expression coincided with the high AMPase activity shown with HEC-1B. Conclusions: Ishikawa, HEC-1B, and ECC-1 cell lines represent a useful cell model for the study of ecto-nucleotidases in the context of endometrioid-type endometrial carcinoma.
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    Editorial: Purinergic pharmacology, Volume II
    (Frontiers Media, 2023-05-16) Ciruela Alférez, Francisco; Jacobson, Kenneth A.
    Extracellular purine nucleotides and nucleosides serve as crucial signalling molecules, acting as neurotransmitters and neuromodulators. Tightly regulated extracellular levels of adenosine 5′-triphosphate (ATP) and adenosine, which are controlled by various enzymes and transporters, activate a variety of purinergic receptors. These receptors, which appear early in evolution, are among the most abundant receptors in living organisms and regulate numerous physiological processes, making them attractive therapeutic targets for a wide range of diseases. While P1 (adenosine) receptors are selective for adenosine, the breakdown product of ATP, P2 receptors respond to purine and pyrimidine nucleotides. Importantly, purinergic receptors, including both G protein-coupled receptors (ARs and P2YRs) and ligand-gated ion channel receptors (P2XRs), are involved in a multitude of neuronal and non-neuronal mechanisms, such as pain, immune responses, exocrine and endocrine secretion, platelet aggregation, endothelium-mediated vasodilatation, and inflammation. However, since purinergic receptors are widely distributed throughout the body, it is challenging to develop drugs that selectively target specific receptor subtypes without causing unwanted side effects. Additionally, extracellular levels of purines and pyrimidines can also vary greatly, leading to the simultaneous activation of different purinergic receptors in response to oscillating concentrations of endogenous purines. Consequently, through these different subtypes of P1 and P2 receptors, cells integrate extracellular purine responses, harmonising short- and long-term purinergic signalling. Therefore, the selectivity of drugs is a crucial goal in the field of purinergic pharmacology. For decades, medicinal chemists have been developing potent and selective synthetic agonists and antagonists for purinergic receptors, as well as allosteric modulators that allow for event-responsive and temporally specific manipulation of the endogenous purinergic system. Additionally, modulation of the metabolism and uptake of extracellular purine nucleotides and nucleosides can also regulate purinergic processes. Overall, the field of purinergic pharmacology is rapidly expanding and presents exciting opportunities for pharmacotherapeutic development.
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    Effect of different wavelengths and powers of laser on surface topography and biofilm removal from titanium implants: an in vitro study
    (BioMed Central, 2025-12-04) Sedrak, Paul Ashraf; Abdelhakim, Ahmed Adel; Arnabat Domínguez, Josep; Rady, Nermeen Abd Elsalam
    Background: This in vitro study aimed to evaluate the effect of using different wavelengths and powers of laser on the surface topography of titanium implants, and to investigate their efficacy in removal of the biofilm complex from the implant surface. Methods: Ten titanium implants, consisting of five new and five failed implants, were randomized and divided into five separate test groups; (Group 1) Erbium Chromium: Yttrium Scandium Gallium Garnet (Er, Cr: YSGG) 2780 nm, (Group 2) Erbium-doped: Yttrium Aluminum Garnet (Er: YAG) 2940 nm, (Group 3) Neodymium-doped: Yttrium Aluminum Garnet (Nd: YAG) 1064 nm, (Group 4) Diode 940 nm, and (Group 5) Diode 445 nm. Each test group consisted of two implants; one new and one failed implant. A total of 160 implant sites were irradiated. Each area was scanned using Scanning Electron Microscope (SEM) prior to and following laser irradiations. A descriptive analysis was conducted by summarizing the data in terms of frequencies and percentages. Pearson Chi Square test and Fisher’s Exact test were used for comparison between different laser type and laser power intensities. The significance level was set at P < .05. Results: Within the parameters under investigation, both Er, Cr: YSGG and Er: YAG lasers displayed no to minimal alterations in surface topography across the different power intensities. Nd: YAG and Diode lasers showed more evident alterations at high power intensities; with Nd: YAG resulting the most prominent damage to the implant surface. Regarding efficacy in removal of biofilm, Er, Cr: YSGG and Er: YAG lasers consistently exhibited positive results across all different power intensities under investigation. In comparison, Nd: YAG and Diode lasers showed inferior efficacy in biofilm removal at low power intensities with significant power-dependent improvements. Conclusions: Er, Cr: YSGG and Er: YAG lasers present superior implant decontamination potential without causing notable implant surface alterations. Diode (940 nm) laser can be used at low power intensities without causing detrimental effects. Nd: YAG and Diode (445 nm) lasers are able to disrupt the biofilm complex but can induce more evident implant surface damage.
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    Concordance and Acceptability of Self‐ Vs. Clinician‐Collected Anorectal Swabs for HPV Genotyping in Gay, Bisexual and Other Men Who Have Sex With Men in Metropolitan Barcelona
    (Wiley, 2026-04-01) Ferrera, Leila; Martínez‐riveros, Héctor; Saña, Miquel; Tous, Sara; Vega, Jaime; Sanchez‐llamas, Mónica; Sirera, Guillem; Néstor García, Jorge; Esteban, Ana; Àngel Pavón, Miquel; Alemany, Laia; Agustí, Cristina; Paytubi, Sònia
    Squamous cell carcinoma of the anus (SCCA), caused by high-risk human papillomavirus (HR-HPV) genotypes, is a growing concern among gay, bisexual, and other men who have sex with men and transgender individuals, particularly those living with HIV. Early detection of precursor lesions is crucial, yet current screening methods face barriers in access and acceptability. Anal self-sampling has emerged as a promising patient-centered alternative. This study evaluates the diagnostic accuracy and feasibility of self-collected anal swabs for HPV genotyping compared to clinician-collected swabs among the target population. A cross-sectional, multicenter study was conducted in the metropolitan area of Barcelona, enrolling 151 participants. Participants provided self- and clinician-collected anal samples, obtained sequentially. Extended genotyping was performed to detect 28 individual HPV genotypes. Diagnostic performance was evaluated using clinician-collected samples as the reference standard, and concordance was assessed using McNemar's test and Cohen's kappa statistic. Feasibility was measured via a questionnaire. Participants had a median age of 43 years, and 53.0% were living with HIV. Overall, HPV was detected in 89.9% of self- and 92.6% of clinician-collected samples. Agreement was high 96.0%, with a kappa value of 0.75 (95% CI: 0.55-0.94). No significant differences were found between methods (p = 0.22). Sensitivity was 96.4% (95% CI: 91.8-98.4), and specificity 90.9% (95% CI: 62.3-98.4), with similar accuracy for HR-HPV and HPV16 types. Most participants rated self-sampling acceptable and feasible. Anal self-sampling shows high accuracy and strong feasibility, supporting its use as a viable and user-friendly strategy to enhance HPV screening in key populations at risk for SCCA.
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    Managing Enterococcus faecium bloodstream infection: a Delphi document on clinical recommendations and research agenda
    (Elsevier, 2026-05-02) Rinaldi, Matteo; Bartoletti, Michele; Cojutti, Piergiorgio; Escolà Vergé, Laura; Fernández Hidalgo, Nuria; Hornuss, Daniel; Gatti, Milo; Gudiol González, Carlota; Gutiérrez-Gutiérrez, Belén; López Cortés, Luis E.; Kern, Winfried V.; Los-Arcos, Ibai; Muñoz, Patricia; Oliva, Alessandra; Papadimitriou-Olivgeris, Matthaios; Pai, Manjunath; Pea, Federico; Pericàs, Juan M.; Rieg, Siegbert; Russo, Alessandro; Soriano Viladomiu, Alex; Thursky, Karin; Udy, Andrew; Venditti, Mario; Yahav, Dafna; Mo, Yin; Viale, Pierluigi; Giannella, Maddalena
    Background: Management of E faecium bloodstream infections (BSIs) remains debated, particularly the clinical impact of vancomycin resistance, the role of follow-up cultures, and optimal therapeutic regimens. This study aimed to reach expert consensus on these unresolved clinical domains and identify priorities for future research. Methods: We first conducted a systematic review and meta-analysis in January 20, 204 focusing on four predefined areas: mortality in E faecium BSIs compared with other BSIs, mortality in vancomycin-resistant enterococci (VRE)-BSIs compared with vancomycin-susceptible enterococci-BSIs, management of catheter-related E faecium BSIs, and 4) optimal antibiotic therapy for VRE-BSIs. These results informed a three-round Delphi process involving a panel of experts. An iterative approach was adopted: 16 initial questions developed from the systematic review (6-point Likert scale) were refined across rounds based on expert feedback. Consensus was defined as at least 80% agreement or disagreement. Findings: 13 statements were generated across three broader domains. Regarding clinical outcomes and diagnostics, experts agreed that mortality is heavily influenced by comorbidities; thus, therapeutic assessment should rely on clinical trends and inflammatory markers, with follow-up blood cultures used to confirm eradication. Catheter-related BSI should be managed with device removal and short-course (<7 days) antibiotics in selected uncomplicated cases. For therapeutic management, teicoplanin is preferred for vanB VRE-BSI. For vanA VRE-BSI, both linezolid and high-dose daptomycin (>9 mg/kg per day) are effective, reserving daptomycin-based combinations for challenging cases (deep-seated infections and/or high Minimum Inhibitory Concentrations). Finally, future trials evaluating the impact of antimicrobial therapy should use Desirability-of-Outcome-Ranking analysis; the in-vitro potential of oritavancin justifies targeted randomized trials to define its clinical efficacy in VRE-BSI. Interpretation: This paper delineates current evidence and expert consensus on management of E faecium BSI while identifying crucial knowledge gaps to guide future clinical research.
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    Genetic risk factors modulate the association between physical activity and colorectal cancer
    (BioMed Central, 2026-03-09) Peoples, Anita R.; Obón Santacana, Mireia; Kim, Andre E.; Kawaguchi, Eric S.; Fu, Yubo; Qu, Conghui; Moratalla Navarro, Ferran; Morrison, John; Lin, Yi; Arndt, Volker; Berndt, Sonja I.; Bien, Stephanie A.; Bishop, D. Timothy; Bouras, Emmanouil; Brenner, Hermann; Buchanan, Daniel D; Campbell, Peter T.; Chan, Andrew T.; Chang-Claude, Jenny; Conti, David V.; Corley, Douglas A.; Devall, Matthew A.; Dimou, Niki; Drew, David A.; Gruber, Stephen B.; Gunter, Marc J.; Harlid, Sophia; Harrison, Tabitha A.; Hoffmeister, Michael; Hsu, Li; Huyghe, Jeroen R.; Keku, Temitope O.; Kundaje, Anshul; Lewinger, Juan Pablo; Li, Li; Lynch, Brigid M.; Le Marchand, Loïc; Martín, Vicente; Murphy, Neil; Newton, Christina C.; Ogino, Shuji; Hardikar, Sheetal; Ose, Jennifer; Pai, Rish K.; Palmer, Julie R.; Papadimitriou, Nikos; Pardamean, Bens; Pellatt, Andrew J.; Pinchev, Mila; Platz, Elizabeth A.; Potter, John D.; Rennert, Gad; Ruiz-Narvaez, Edward; Sakoda, Lori C.; Schoen, Robert E.; Shcherbina, Anna; Stern, Marianna C.; Su, Yu-Ru; Thomas, Claire E.; Tian, Yu; Tsilidis, Konstantinos K.; Um, Caroline; van Duijnhoven, Franzel J.B.; Van Guelpen, Bethany; Visvanathan, Kala; Wang, Junzhi; White, Emily; Wolk, Alicja; Woods, Michael O.; Wu, Anna H.; Ulrich, Cornelia M.; Peters, Ulrike; Gauderman, W. James; Moreno Aguado, Víctor
    Background: Physical activity is an established protective factor for colorectal cancer (CRC), but it is unclear if genetic variants modify this effect. To investigate this possibility, we conducted a genome-wide gene–physical activity interaction analysis. Methods: Using logistic regression (1-d.f), two-step screening and testing method (EDGE), and joint tests (3-d.f), we analyzed interactions between common genetic variants across the genome and physical activity in relation to CRC risk. Self-reported physical activity levels were categorized as active (≥ 8.75 MET-h/wk) vs. inactive (< 8.75 MET-h/wk; 39,992 participants) and as study- and sex-specific quartiles of activity (42,602 participants). Results: Physical activity was inversely associated with CRC risk overall (OR [active vs. inactive] = 0.85; 95% CI = 0.81–0.90). The two-step EDGE method identified an interaction between rs4779584, an intergenic variant near the GREM1 and SCG5 genes, and physical activity for CRC risk (p-interaction = 2.6 × 10−8). Stratification by genotype at this locus showed a significant reduction in CRC risk by 20% in active vs. inactive participants with the CC genotype (OR = 0.80; 95% CI = 0.75–0.85), but no significant physical activity–CRC associations among CT or TT carriers. When physical activity was modeled as quartiles, the 1-d.f. test identified that rs56906466, an intergenic variant near the KCNG1 gene, modified the association between physical activity and CRC (p-interaction = 3.5 × 10−8). Stratification at this locus showed that an increase in physical activity (highest vs. lowest quartile) was associated with a lower CRC risk solely among TT carriers (OR = 0.77; 95% CI = 0.72–0.82). Conclusions: In summary, we identified two genetic variants that modified the association between physical activity and CRC risk. One of them, related to GREM1 and SCG5, suggests that the bone morphogenetic protein (BMP)-related, inflammatory, and/or insulin signaling pathways may be involved in the protective association between physical activity and colorectal carcinogenesis.
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    Macrolide resistance determinants and their associations in streptococci from selected livestock and wildlife species from Catalonia, Northeast Spain
    (American Society for Microbiology, 2026-03-16) López de Egea, Guillem; González-Díaz, Aida; Aragon, Virginia; Cabezón Ponsoda, Òscar; Guédon, Gérard; Berbel, Dàmaris; Cadenas Jiménez, Irene; Espunyes, Johan; Planellas, Marta; Domínguez Luzón, Ma. Ángeles (María Ángeles); Leblond Bourget, Nathalie; Ardanuy Tisaire, María Carmen
    The increasing macrolide resistance in Streptococcus spp. causing human and animal infections in the last decades is a concern for global health. The objectives of this study were to analyze the macrolide resistance rates of Streptococcus spp. from animals and their resistance determinants. We conducted a retrospective study of an animal Streptococcus collection (307 isolates) from farm, wild animals, and pets in Catalonia, Northeast Spain. Identification was done by MALDI-TOF, and antimicrobial susceptibility to erythromycin and clindamycin was assessed by disk diffusion (EUCAST). Resistant strains were further tested for susceptibility to other antimicrobial agents using disk diffusion and microdilution methods. Selected isolates (n = 50) were subjected to whole-genome sequencing (WGS). Mobile genetic elements (MGEs), such as integrative and conjugative elements (ICEs) and integrative and mobilizable elements (IMEs), were identified using ICEscreen. Streptococcal strains were mainly isolated from domestic swine (50.5%) and wild boars (19.2%), with S. suis (54.4%) and S. hyovaginalis (14%) the predominant species. The macrolide resistance phenotypes found were MLSB (n = 145), M (n = 6), and L (n = 30). Macrolide (84.5%) and lincosamide (94.8%) resistance rates from swine strains were higher than those from other animals (13.2% and 18.4%, respectively, P < 0.001). The predominant resistant genes found were erm(B) (n = 38), tet(O) (n = 28), vga(F) (n = 20), and lnu(B)-lsa(E) (n = 10), and were mostly associated with ICEs or defective ICEs (dICEs) belonging to the Tn5252 family. Animal streptococci presented high macrolide resistance rates, especially concerning swine strains, associated with a variety of resistance determinants. MGEs were the main carriers of resistance determinants and contributors to its spread.
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    Inequities in Waiting Times for Major Elective Surgery Before and After the COVID-19 Pandemic: Socioeconomic and Sex Differences in the Southern Barcelona Metropolitan Area
    (MDPI, 2026-03-01) Pericas Escale, Carles; Vilaplana Carnerero, Carles; Poltorak, Violeta; Redondo, Ana; Masuet Aumatell, Cristina; Tor Roca, Alba; Pagès Fernández, Constança; Grau, María
    Background: Waiting times for elective surgery are widely used as indicators of health system performance, particularly following the disruption caused by COVID-19. The objective of this study is to compare the waiting times for major elective surgeries in the Southern Barcelona Metropolitan Area before (2018–2019) and after (2022–2023) the pandemic, examining differences according to sociodemographic characteristics. Methods: A retrospective comparative study was conducted using data from the Southern Barcelona Metropolitan Area between 2018 and 2023. Adults registered on the waiting list for major elective surgical procedures were included. All analyses were stratified by sex. A stratified pre–post pandemic analysis was conducted to examine differences in waiting times by Socioeconomic Index. Waiting times were modelled using generalized linear models with a Gamma distribution and log link, adjusting for age and Socioeconomic Index quartiles. Interaction between period and Socioeconomic Index was tested. Results: The analysis included 73,055 individuals (50.5% women). Median waiting time decreased after the COVID-19 pandemic for both sexes (women: 128 to 121 days; men: 99 to 94 days). This reduction showed an inverse socioeconomic gradient. Adjusted analyses showed longer waits in the lowest versus highest Socioeconomic Index quartile after the pandemic (women: RR = 1.23; men: RR = 1.30). Conclusions: Waiting times for major elective surgery decreased after COVID-19. An exclusive focus on waiting time indicators may conceal structural barriers to access and contribute to inequalities. Equity-sensitive monitoring of elective care is essential to ensure a fair recovery of surgical services.
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    Inpatient hospital admissions for people with obsessive-compulsive disorder (OCD). A position statement by the international college of obsessive-compulsive spectrum disorders
    (Elsevier B.V., 2026-04) Brakoulias, Vlasios; Albert, Umberto; Chamberlain, Samuel R.; Dell'Osso, Bernardo; Ferretti, Casara J.; Girone, Nicolaja; Hollander, Eric, 1957-; Ioannidis, Konstantinos; Lochner, Christine; Menchón Magriñá, José Manuel; Mpavaenda, Davis; Pallanti, Stefano; Pampaloni, Ilenia; Pellegrini, Luca; Stein, Dan J., 1962-; Van Ameringen, Michael; Zohar, Joseph; Fineberg, Naomi A.
    Background: The hospitalization of patients with obsessive-compulsive disorder (OCD) is less common in comparison to other mental disorders, and often a significant and distressing event. Objectives: This paper presents a position statement, developed by the International College of Obsessive-Compulsive Spectrum Disorders, on the indications for hospital admission for people with OCD, the treatment that is offered within hospital, the complications that may occur in this setting, and principles for best practice. Methods: Current literature was critically reviewed and narratively synthesized by a group of international experts in the field of OCD. Results; An inpatient hospital admission may be required for people with severe OCD who are unable to accept or tolerate pharmacological or psychological treatment as an outpatient or where there would be significant risks to the individual or those around them. Admissions have been associated with significant reductions in OCD severity. Inpatient treatment often involves psychoeducation of staff, patients and family members, pharmacotherapy, exposure and response prevention psychological work, addressing comorbidity as well as psychosocial issues such as family-relational issues, homelessness, grief or loss. Admissions can be distressing, and intensive inpatient-based therapy programs require the comprehensive assessment of risk. Conclusions: The inpatient treatment of people with OCD is an important management option that needs to be well considered and managed. Admissions often require close monitoring of risks, additional support to staff who may be unfamiliar with OCD, addressing comorbidity, pharmacotherapy and exposure and response prevention therapy.
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    Iron Matters: Comparative Impact of Beta-Adrenergic Stimulation and Iron Chelation on Cardiac Iron Metabolism and Mitochondrial Function
    (MDPI, 2026-04-14) Francesch Manzano, Josep; Comín Colet, Josep; Tajes Orduña, Marta; Ramos Polo, Raúl; Enjuanes, Cristina; Ras Jiménez, Maria del Mar; Cosa, Andreea Eunice; Marinova, Katrin; Enrich Soria, Carla; Moliner, Pedro; Lorenzo Esteller, Laia; Jose Bazán, Núria
    Iron deficiency (ID) is frequent in patients with heart failure (HF) and is correlated with adverse outcomes, yet its involvement in HF pathophysiology is not fully understood. Hyperactivity of the sympathetic nervous system (SNS) is the central feature of HF. We aimed to compare the effects of isoproterenol (ISO), a β-adrenergic agonist (SNS stimulation), with those of the iron chelator deferoxamine (DEF), to evaluate how β-adrenergic stimulation influences cardiac iron. In this study, H9c2 cardiac cells were challenged with ISO, DEF or both and several parameters related to iron metabolism were analyzed. In all cases, the cells decreased their intracellular iron levels. ISO induced alterations in key cardiac iron metabolism molecules that were, in most cases, comparable to those elicited by DEF, emphasizing the direct impact of β-adrenergic stimuli on iron metabolism and mitochondrial dysfunction. Nevertheless, unlike DEF, ISO triggered a shift in mitochondrial energy metabolism. These findings suggest that β-adrenergic stimulation, as a major component of neurohormonal activation, may contribute to the development of ID in cardiac cells, highlighting the importance of iron homeostasis and the need to further investigate iron dysregulation in this context.
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    Indocyanine green fluorescence for intraoperative detection of liver tumours in minimally invasive surgery: protocol for the LIVERGREEN phase IV multicentre clinical trial
    (BMJ Publishing Group, 2026-04-16) Huerta, Martín; López Ben, Santiago; Lladó Garriga, Laura; Sánchez Cabús, Santiago; Mils, Kristel; Molina, Víctor; Dopazo, Cristina; Vidal, Laura; Dalmau, Mar; Caralt, Mireia; Rosón, Núria; Merino, Xavier; Armario, David; Salcedo Allende, María Teresa; Pellino, Gianluca; Sapisochin, Gonzalo; Gómez Gavara, Concepción; Pérez, Núria; Roig, Anna; Sanjuan, Anna; Pérez, Santiago; Sánchez Maroto, Olga; Delgado, Esther; Cabau, Claudia; Villasante, Sara; Galiana, Carmen; Herms, Daniel; Valencia, Sebastián; Cañete, Marta; García, Oliver; Barrios, Oriana; Vila, Marina; Leiva Ureña, David; Layreda, Karen
    Introduction: Liver tumours are a leading cause of global morbidity and mortality. Current diagnostic tools, including computed tomography (CT), magnetic resonance imaging (MRI) and intraoperative ultrasound (IOUS), have limitations in detecting liver neoplasms. Indocyanine green (ICG) has emerged as a promising tool for improving liver tumour detection. This study aims to assess the impact of preoperative ICG on intraoperative tumour detection in minimally invasive surgery and develop a machine-learning algorithm to enhance tumour detection using ICG fluorescence. Methods and analysis: This prospective, multicentre, phase IV clinical trial adheres to Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. Patients with liver tumours eligible for minimally invasive surgery and a preoperative imaging test will be included. ICG will be administered intravenously 24 hours before surgery. Intraoperative procedures will include IOUS, ICG mapping and photographic documentation. Patients will be followed for 90 days to assess tumour progression, morbidity and mortality. The photographic analysis will enable the development of an artificial intelligence algorithm using machine learning and neural networks to identify lesions based on ICG fluorescence. The estimated sample size is 173 patients and the trial is predicted to accrue in 3 years. Ethics and dissemination: The trial will be conducted in accordance with the Declaration of Helsinki and the Spanish Agency of Medicines and Medical Devices (AEMPS) guidelines. Approved by the local institutional Ethics Committee and the AEMPS, the results will be shared with the scientific community through publications and conferences.