Ana-Belen Larque’s research while affiliated with Hospital Clínic de Barcelona and other places

Background Total knee arthroplasty (TKA) is an effective surgical procedure for managing advanced osteoarthritis of the knee, significantly reducing pain and improving function. However, some patients experience complications leading to revision surgery, often caused by periprosthetic joint infection (PJI) in early failures and adverse local tissue reactions (ALTR) or aseptic loosening in late failures. Differentiating between PJI and ALTR is crucial because their clinical presentations can overlap, yet their treatments are distinct. While traditional imaging like radiography is useful for assessing alignment and detecting osteolysis, it may miss subtle pathological changes. Computed tomography (CT) has been increasingly utilized to provide additional diagnostic detail, especially regarding lymphadenopathy, which has been linked to septic complications in hip prostheses. However, the role of popliteal lymphadenopathy (PLN) in knee prosthesis complications remains unexplored. Case Description We present three cases of knee prosthesis complications, diagnosed as either septic or aseptic, where CT imaging revealed distinct patterns of PLN. In the first case, which involved septic loosening, three enlarged PLNs with rounded morphology, normal density, and an absent fatty hilum were observed. The second case, complicated by ALTR and a periprosthetic fracture, showed six PLNs with increased cortical density but a preserved fatty hilum. The third and final case of aseptic loosening revealed three PLNs with increased cortical density and prosthetic debris in the popliteal recess. These findings suggest a range of PLN characteristics depending on the underlying complication, with distinct differences in morphology and cortical density observed between septic and aseptic cases. Conclusions The presence and characteristics of PLN may serve as a valuable imaging biomarker for diagnosing and differentiating knee prosthesis complications. CT evaluation of PLNs could enhance diagnostic accuracy, particularly in distinguishing between PJI and ALTR, prompting further research to validate these findings and explore their diagnostic potential.

Background Gastric cancer (GC) is the fifth most common cancer globally and the third leading cause of cancer-related deaths. While it predominantly metastasizes to the liver, peritoneum, and lungs, bone metastasis (BM) is a rare but severe complication. BM occurs in 1–20% of GC cases and is associated with a poor prognosis. Typically, BM in GC presents at advanced stages, often with non-specific symptoms, making early detection challenging. Case Description This retrospective study analyzed 118 GC patients treated at our institution from 2010 to 2020. Among them, eight patients (6.8%) developed BM, with an equal split between osteoblastic and osteolytic types. Osteoblastic BM was observed exclusively in men, with a mean age of 72.25 years. The median time from GC diagnosis to BM onset was 27.5 months. BM was primarily detected through periodic thoracoabdominal CT scans, and bone scintigraphy confirmed the osteoblastic nature of the lesions. All patients had advanced GC and were under palliative care at the time of BM diagnosis. The average survival time from BM diagnosis was 8.5 months. Conclusions BM in GC patients is rare but significantly worsens the prognosis. The findings suggest that osteoblastic BM may be more common in GC than previously reported, potentially due to improved imaging techniques and extended patient survival. This study underscores the importance of vigilant radiological monitoring in GC patients, particularly those with non-specific symptoms suggestive of BM. Enhanced collaboration between oncology and palliative care teams is essential to manage symptoms effectively and improve patient quality of life. Future research should focus on the incidence and management of BM in GC, particularly the role of targeted therapies in improving patient quality of life. Keywords Bone metastasis (BM); gastric cancer (GC); osteoblastic; disease progression; case report

The transplant community is focused on prolonging the ex vivo preservation time of kidney grafts to allow for long-distance kidney graft transportation, assess the viability of marginal grafts, and optimize a platform for the translation of innovative therapeutics to clinical practice, especially those focused on cell and vector delivery to organ conditioning and reprogramming. We describe the first case of feasible preservation of a kidney from a donor after uncontrolled circulatory death over a 73-h period using normothermic perfusion and analyze hemodynamic, biochemical, histological, and transcriptomic parameters for inflammation and kidney injury. The mean pressure and flow values were 71.24 ± 9.62 mmHg and 99.65 ± 18.54 mL/min, respectively. The temperature range was 36.7°C–37.2°C. The renal resistance index was 0.75 ± 0.15 mmHg/mL/min. The mean pH was 7.29 ± 0.15. The lactate concentration peak increased until 213 mg/dL at 6 h, reaching normal values after 34 h of perfusion (8.92 mg/dL). The total urine output at the end of perfusion was 1.185 mL. Histological analysis revealed no significant increase in acute tubular necrosis (ATN) severity as perfusion progressed. The expression of KIM-1, VEGF, and TGFβ decreased after 6–18 h of perfusion until 60 h in which the expression of these genes increased again together with the expression of β-catenin, Ki67, and TIMP1. We show that normothermic perfusion can maintain a kidney graft viable ex vivo for 3 days, thus allowing a rapid translation of pre-clinical therapeutics to clinical practice.