Clinica Rotger

Background/Objectives: Penile prosthesis implantation is a safe and effective treatment for erectile dysfunction, with low complication rates. Glans ischemia is a rare but serious postoperative complication that can lead to irreversible tissue loss. However, not all postoperative glans color changes reflect true ischemia, and distinguishing reversible from irreversible perfusion compromise remains challenging. The objective was to describe the clinical course, management, and outcomes of four patients who developed glans color changes following penile prosthesis implantation, emphasizing the role of glans sensibility in guiding treatment. Methods: We conducted a retrospective case series supplemented with a narrative literature review. Clinical data were obtained from medical records, operative reports, and follow-up visits. Literature searches were performed using PubMed, Scopus, and Google Scholar. Results: Four patients developed postoperative glans discoloration. Two patients, with preserved glans sensibility and no evidence of tissue necrosis, were managed conservatively with cylinder deflation and removal of compressive dressings, resulting in full recovery without tissue loss. Two patients, who exhibited impaired glans sensitivity, developed progressive ischemia. One had prior pelvic radiation, and the other underwent combined grafting and glanspexia. Both required surgical debridement and reconstruction, with permanent tissue loss. Conclusions: Glans color changes after penile prosthesis implantation do not always indicate irreversible ischemia. Preserved glans sensibility is a useful clinical marker of potentially reversible perfusion compromise and may support a conservative management strategy with close monitoring. Conversely, loss of sensation and necrosis should prompt urgent consideration of prosthesis explantation to prevent further tissue loss.

unified cohort of 134 patients was formed using tissue microarrays from two sarcoma centers: 109 cases from MD Anderson Cancer Center and 25 from Fred Hutchinson Cancer Center (FHCC).Two mIHC panels were used: CD4, CD68/CD163, CD8, FoxP3, PD-1, PD-L1 (with post-mIHC ERG DAB) and CD68, CD20, CD3, CD163, CD206, CD34.Transcriptomic analysis was performed using the NanoString IO 360 panel on 25 angiosarcoma samples from FHCC with 9 hemangiomas as controls. Results:We observed significant differences in immune cell infiltration between cutaneous and non-cutaneous angiosarcomas, with higher levels of CD20+ B-cells (p=0.015),CD3+ T-cells (p=0.007),CD8+ T-cells (p< 0.001), FOXP3+ regulatory Tcells (p< 0.001), PD1+ cells (p=0.004) and CD4+ T-cells (p=0.015) in cutaneous tumors.Survival analysis demonstrated that higher CD20+ B-cell infiltration was significantly associated with improved overall survival (p=0.014).Gene expression analysis revealed higher MAPK pathway-related transcripts including MAP4K2 and MAPKAPK2 in angiosarcomas.Angiosarcomas also had higher complement levels (C5/C6), and lower expression of interleukin 1 receptor antagonist (IL1RN).When comparing angiosarcoma subtypes, scalp/face tumors showed distinctive immune profiles with lower complement expression and higher expression of inflammatory markers S100A8, S100A9, NOD2, and IL1B; paired with higher CD3+ and CD4+ cell infiltration on mIHC compared to other sites. Conclusion:These findings provide insights into the immunological landscape of angiosarcomas across different anatomical locations.The significantly higher immune infiltration in cutaneous versus non-cutaneous angiosarcomas suggests distinct immunological mechanisms, consistent with higher immunotherapy responsiveness in cutaneous angiosarcomas.Our results suggest that immune cell infiltration, particularly CD20+ B-cells, may serve as prognostic biomarkers in this rare disease.

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Variant transthyretin (ATTRv) amyloidosis is a rare, inherited disorder caused by mutations in the TTR gene, leading to amyloid fibril deposition. The Balearic Islands are a known endemic focus for the NP_000362.1:p.Val50Met (V30M) variant, one of the most prevalent pathogenic mutations. We analysed 23 years of genetic testing data from the Balearic Islands’ public health system to determine the prevalence and distribution of ATTR pathogenic variants, with a focus on V30M. A total of 1,478 individuals underwent genetic testing, with 319 positive tests for ATTRv: 308 carried the V30M variant (96.4%) and 11 carried other pathogenic variants. The V30M prevalence was highest in Mallorca and Menorca (1 in 2,900 and 4,700, respectively), with lower rates in Ibiza and Formentera. The co-occurrence of V30M and NP_000362.1:p.Gly26Ser (G6S) on the same chromosome in 93% of V30M carriers suggests a common origin. This study becomes the first registry of ATTRv in the Balearic Islands, aiming to raise awareness among clinicians across all areas and services while enabling more accurate diagnostics, informed genetic counselling, and targeted clinical follow-ups. We also postulate the Balearic Islands as a major global focus for the V30M variant, with a distinct genetic profile suggesting a unique founder effect within the region.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-14707-4.

<bold>Introduction:</bold> Patients with severe uncontrolled asthma (SUA) considered candidates for biologic therapy (BT) may suffer from hidden aggravating factors that play a role in not achieving control, among them subacute infections. <bold>Objective:</bold> To determine the role of infection in SUA patients who are candidates for biological therapy and the final indication of BT after treating infection. <bold>Material and methods:</bold> observational study of consecutive stable SUA patients candidates for biologic therapy who underwent bronchoscopy and microbiological culture of bronchial aspirate (BAS) as part of their asthma work-up. Patients with growth of potentially pathogenic bacteria (PPB) or fungus received targeted antibiotic or antifungal therapy. Epidemiological and clinical characteristics and the need for biologic initiation 6 months after bronchoscopy were evaluated. <bold>Results:</bold> Seventy-eight patients were included (mean age 58±14 years, 96% eosinophilic T2 phenotype, ACT 15±4, annual exacerbations rate 4±3, post-bronchodilator FEV1 68±19%). 27 patients (35%) had growth of PPB or fungi in BAS, of which 13 (48%) had CT-diagnosed bronchiectasis. The most frequent PPB isolated were Pseudomonas aeruginosa (8), Staphylococcus aureus (6), Aspergillus spp (6) and Haemophilus influenzae (3). 24 out of 27 received targeted therapy and after 6-month follow-up 7 patients started biologics (26%) and 20 did not (74%). <bold>Conclusions:</bold> Respiratory tract infections in patients with SUA may act as a hidden aggravating factor leading to poor control. The appropriate treatment could delay or avoid the initiation of BT. Supported by FIS 19/07521

Abstract A 2‐year‐old, male, neutered chihuahua was referred to the neurology service with a 3‐week history of progressive weakness of both pelvic limbs. A myelo‐computed tomography and high field magnetic resonance imaging of the thoracolumbar vertebral column identified a large, focal, intradural‐extramedullary mass in the T12–L1 region of the vertebral canal. Histopathological analysis was compatible with a spinal cord nephroblastoma. The dog was treated with toceranib, but was euthanased due to lack of improvement. To the authors’ knowledge, this is the first report of a spinal cord nephroblastoma in a chihuahua and the first report that describes the use of toceranib for this tumour type.

The development of power instruments has led to great advances in rhinoplasty. It has helped to reduce operating time, minimize damage to the surrounding soft tissues, and allow precision bony modification compared with the use of manual rasps. Burrs help ensure precise results by (i) creating a smooth transition between the lateral nasal sidewall and the face, (ii) treating bony asymmetries, and (iii) producing homogeneous upper and middle thirds that softy translate into the upper lateral cartilages. The aim of this paper is to show applications of cylindrical burrs in rhinoplasty surgery to treat the dorsal upper and middle thirds as well as lateral sidewalls of the nose, regardless of whether the dorsal preservation or structure technique is used. This approach offers a safe, fast, and precise technique that can be used in conjunction with piezo osteotomy to obtain the optimal outcomes.