Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements.

BACKGROUND: Recent non-invasive 3D photography method has been applied to facial analysis, offering numerous advantages in orthodontic. The purpose of this study was to analyze the faces of a sample of healthy European adults from southern Spain with normal occlusion in order to establish reference facial soft tissue anthropometric parameters in this specific geographic-ethnic population, as well as to analyze sexual dimorphism. METHODS: A sample of 100 healthy adult volunteers consisting of 50 women (mean age, 22.92 ± 1.56 years) and 50 men (mean age, 22.37 ± 2.12 years) were enrolled in this study. All participants had normal occlusion, skeletal Class I, mesofacial pattern, and healthy body mass index. Three-dimensional photographs of the faces were captured non-invasively using Planmeca ProMax 3D ProFace®. Thirty landmarks related to the face, eyes, nose, and orolabial and chin areas were identified. RESULTS: Male displayed higher values in all vertical and transversal dimensions, with the exception of the lower lip height. Larger differences between sexes were observed in face, mandible, and nose. Male also had higher values in the angular measurements which referred to the nose. No sex differences were found in transverse upper lip prominence or transverse mandibular prominence. No differences were found in the ratio measurements, with the exception of intercantal width/nasal width, which was higher in women than in men. CONCLUSIONS: Reference anthropometric measurements of facial soft tissues have been established in European adults from southern Spain with normal occlusion. Significant sexual dimorphism was found, with remarkable differences in size between sexes.

WITHDROWN: Effect of smoking habit on crestal bone height in maxillary sinus augmentation with bone grafts.

In relation to the article with reference "Carreño-Carreño J, Gómez-Moreno G, Aguilar-Salvatierra A, Menéndez-López-Mateos C, Piattelli A, Menéndez-Núñez M. Effect of smoking habit on crestal bone height in maxillary sinus augmentation with bone grafts. Med Oral Patol Oral Cir Bucal. (2018), doi:10.4317/medoral.22439", published in Oral Medicine Oral Pathology and Oral Surgery in the modality "AHEAD OF PRINT - article in press", the authors mention that "The study was conducted according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) Statement". However, and based on the opinion of several expert reviewers who have re-evaluated the article, it is considered that although "there has not been plagiarism", these STROBE criteria are not adequately met. In addition, the mentioned article is very similar to two articles that have already been published by the same authors in Clinical Oral Implants Research. The sample is the same; many data are repeated; and the only difference is the inclusion of a variable (smoking), which does not exert a significant effect. This outcome therefore would not justify publication of the paper in the journal. Retraction of the article is therefore decided.

Can nonalcoholic beer, silicon and hops reduce the brain damage and behavioral changes induced by aluminum nitrate in young male Wistar rats?

Aluminum consumption has been associated with various neurodegenerative diseases. Previous studies suggest that regular beer intake reverses the pro-oxidant and inflammatory statuses induced by aluminum nitrate intoxication. This paper aims to evaluate the in vitro antioxidant capacity and acetylcholinesterase inhibitory activity of non-alcoholic beer (NABeer), silicon or hops, as well as their effect on animal behavior (e.g. curiosity, immobilization, rearing, grooming, swimming) and brain antioxidant enzyme (activity and gene expression) and anti-inflammatory status in aluminum nitrate intoxicated rats. Male Wistar rats were divided into five groups: 1) Control, 2) Aluminum nitrate (450 µg/kg/day), 3) Aluminum nitrate plus NABeer, 4) Aluminum nitrate plus hops, and 5) Aluminum nitrate plus silicon. Hops showed the highest in vitro antioxidant capacity and silicon the highest anticholinesterase activity. In the Aluminum group the brain aluminum/silicon ratio increased with impairment of brain antioxidant and inflammatory statuses. NABeer, silicon and hops block the negative effect on the in vivo antioxidant and inflammatory statuses induced by Aluminum nitrate and improve swimming and rearing behavioral tests. The various positive results suggest that NABeer is useful as a functional multi-target drink in the prevention of some neurodegenerative events caused by aluminum intoxication. More studies are required to conclude present results.

Discovery of novel drug sensitivities in T-PLL by high-throughput ex vivo drug testing and mutation profiling.

T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive neoplasm of mature T-cells with an urgent need for rationally designed therapies to address its notoriously chemo-refractory behavior. The median survival of T-PLL patients is <2 years and clinical trials are difficult to execute. Here we systematically explored the diversity of drug responses in T-PLL patient samples using an ex vivo drug sensitivity and resistance testing platform and correlated the findings with somatic mutations and gene expression profiles. Intriguingly, all T-PLL samples were sensitive to the cyclin-dependent kinase inhibitor SNS-032, which overcame stromal-cell-mediated protection and elicited robust p53-activation and apoptosis. Across all patients, the most effective classes of compounds were histone deacetylase, phosphoinositide-3 kinase/AKT/mammalian target of rapamycin, heat-shock protein 90 and BH3-family protein inhibitors as well as p53 activators, indicating previously unexplored, novel targeted approaches for treating T-PLL. Although Janus-activated kinase-signal transducer and activator of transcription factor (JAK-STAT) pathway mutations were common in T-PLL (71% of patients), JAK-STAT inhibitor responses were not directly linked to those or other T-PLL-specific lesions. Overall, we found that genetic markers do not readily translate into novel effective therapeutic vulnerabilities. In conclusion, novel classes of compounds with high efficacy in T-PLL were discovered with the comprehensive ex vivo drug screening platform warranting further studies of synergisms and clinical testing.

A high migratory capacity of donor T-cells in response to the lymph node homing receptor CCR7 increases the incidence and severity of GvHD.

The pathogenesis of GvHD involves migration of donor T-cells into the secondary lymphoid organs in the recipient, which is steered by two homing molecules, CD62L and CCR7. Therefore, we investigated whether the migratory capacity of donor T-cells is associated with GvHD. This single center prospective study included 85 donor-recipient pairs. In vitro chemotaxis assays of the lymphocytes of the apheresis product were performed in parallel to the analysis of CD62L and CCR7 by flow cytometry. The migratory index to the CCR7 ligands, CCL19 and CCL21, was higher in T-cells from donors whose recipients will develop GvHD. Similarly, the acute GvHD (aGvHD) group received higher percentage of CD4+CCR7+ T-cells, whereas chronic GvHD (cGvHD) patients were transplanted with higher percentages of CD8+CCR7+ T-cells compared with the non-GvHD group. These results were confirmed when patients were subdivided according to degrees of severity. Further, multivariate analysis confirmed that the proportions of CCR7+ CD4+ and CCR7+ CD8+ T-cells are risk factors for the development and severity of aGvHD and cGvHD, respectively. Functional experiments demonstrated that CCR7+ T-cells exhibited higher potential for activation than CCR7- T-cells did. We therefore propose that the selective depletion of CCR7-expressing T-cells may be an effective preventive therapy for GvHD.

Follow-up monoclonal gammopathy of undetermined significance in kidney transplant.

OBJECTIVE: The aim of this work was to review the incidence of monoclonal gammopathy of undetermined significance (MGUS) and complications in kidney transplant (KT) patients at the Puerta del Mar Hospital in Cádiz, Spain. This diagnosis was not considered to be a contraindication for transplantation. METHODS: To estimate the incidence of MGUS in KT patients we used the database of our hospital, which included 1,016 patients who received a KT from 1992 to 2012 with a median follow-up of 30 months. The incidence of MGUS in non-transplant patients was estimated from the literature. RESULTS: Out of 1,016 KT patients, 16 developed MGUS; 10 (72.5%) were >50 years old. Two patients developed post-transplantation lymphoproliferative disorders. No cases of progression to multiple myeloma or amyloidosis were seen during immune suppression therapy or after. CONCLUSIONS: MGUS was >100 times more frequent in KT recipients than in the general population (P < .05). But in contrast to MGUS in general population, progression to plasma cell dyscrasia in these patients was absent and its incidence is unknown in KT patients.

Autoantibodies against TIF-1-γ and CADM-140 in Spanish patients with clinically amyopathic dermatomyositis (CADM): clinical significance and diagnostic utility.

BACKGROUND: Patients with clinically amyopathic dermatomyositis (CADM) appear to be at risk for developing cancer and interstitial lung diseases, but population data to confirm this hypothesis are limited. Moreover, CADM presents cutaneous and histological findings that may overlap with subacute cutaneous lupus erythematosus (SCLE). OBJECTIVES: To determine the association between myositis-specific autoantibodies, myositis-associated autoantibodies and CADM in Spanish patients. In addition, to study the usefulness of these autoantibodies in the differential diagnosis between CADM and SCLE. METHODS: Serum samples were tested for myositis-specific autoantibodies and myositis-associated autoantibodies through immunoprecipitation and other standardized methods. RESULTS: Anti-CADM-p140 and anti-p155 antibodies were the only myositis-specific autoantibodies found and were associated with interstitial lung diseases and cancer respectively. No myositis-associated autoantibodies were found in CADM. Moreover, clinical subsets and proportions seemed to differ from Asian cohorts, where anti-CADM-p140 is considered a CADM hallmark antibody and a risk factor for the development of interstitial lung disease. Interestingly, anti-SSA was highly associated with SCLE, whereas no myositis-specific autoantibodies were found in this entity. LIMITATIONS OF THE STUDY: Association between CADM and myositis-specific autoantibodies and differences between CADM and SCLE were tested on a relatively small cohort of patients. CONCLUSION: There is an association between cancer-associated myositis and interstitial lung diseases and their hallmark autoantibodies in our cohort. In addition, the combined determination of myositis-specific autoantibodies and SSA autoantibodies may help to accurately discriminate SCLE from CADM.

[Horizontal sensory strabismus: characteristics and treatment results]. / Características y resultados del tratamiento del estrabismo sensorial horizontal.

PURPOSE: To study the types of horizontal sensory strabismus, their causes, and treatment outcomes. METHODS: A retrospective analysis of 44 patients with horizontal sensory strabismus who were treated from 2002 to 2007. Patients whose worse eye vision was inferior or equal to 0.2 were included. The deviation angle in primary position, causes, type of treatment, and pre-operative or post-operative diplopia were studied. A good result was considered if the final deviation was less than 10 prism diopters (pd). RESULTS: Of the patients studied, 63.6% had exotropia and the 36.4% had esotropia. The visual acuity was between 0.1 and no light perception in 75% of patients. The causes responsible for low vision were congenital in 28, and acquired in 16 cases. The mean deviation was 46.7 pd. Diplopia was present in 5 cases, which were resolved with surgical treatment in 3 of them. The eye with reduced vision was operated on in 37 patients, both eyes in 6 cases, and botulinum toxin was injected in 1 case. The final outcome was successful in 90.6% of the cases which were surgically treated. The mean follow up was 31.84 months. CONCLUSIONS: There were twice as many exotropias as esotropias. Strabismus surgery of the amblyopic eye shows excellent results without the need of new operations. There were no new diplopia cases.

Caracteristicas y resultados del tratamiento del estrabismo sensorial horizontal / Horizontal sensory strabismus: characteristics and treatment results

PropositoEstudiar los tipos de estrabismo sensorial horizontal, sus causas y los resultados obtenidos con el tratamiento.Metodo de Estudio retrospectivo de 44 casos diagnosticados y tratados de estrabismo sensorial horizontal entre 2002 y 2007. Se incluyeron los pacientes con una AV ¡Ü de 0,2 en el ojo con peor vision. Se estudiaron la desviaci¨®n en PM, las causas, el tipo de tratamiento realizado, y la presencia de diplop¨ªa pre y postoperatoria. Se consider¨® buen resultado si la desviaci¨®n final era ¡Ü 10 dioptr¨ªas prism¨¢ticas (dp).ResultadosEn el 63,6% de los casos se diagnostic¨® una exotrop¨ªa (XT) y en el 36,4% una endotropia (ET). El 75% de los pacientes tenia una AV entre 0,1 y NPL. Las causas fueron congenitas en 28 y adquiridas en 16 casos. La desviaci¨®n media fue de 46,7 dp. En 5 casos hab¨ªa diplop¨ªa que se resolvi¨® en 3 con el tratamiento. No hubo nuevos casos de diplop¨ªa postoperatoria. La cirug¨ªa se realiz¨® solo en el ojo ambliope en 37 pacientes, en 6 en AO, y en 1 se inyect¨® toxina botul¨ªnica. El resultado quir¨²rgico fue bueno en el 90,6%. El tiempo de evoluci¨®n fue de 31,84 meses.ConclusionesLas XT han sido casi el doble que las ET. La cirug¨ªa ha conseguido muy buenos resultados, con un m¨ªnimo de reintervenciones, operando solo el ojo ambliope. No hubo diplop¨ªas postoperatorias(AU)

PurposeTo study the types of horizontal sensory strabismus, their causes, and treatment outcomes.MethodsA retrospective analysis of 44 patients with horizontal sensory strabismus who were treated from 2002 to 2007. Patients whose worse eye vision was inferior or equal to 0.2 were included. The deviation angle in primary position, causes, type of treatment, and pre-operative or post-operative diplopia were studied. A good result was considered if the final deviation was less than 10 prism diopters (pd).ResultsOf the patients studied, 63.6% had exotropia and the 36.4% had esotropia. The visual acuity was between 0.1 and no light perception in 75% of patients. The causes responsible for low vision were congenital in 28, and acquired in 16 cases. The mean deviation was 46.7 pd. Diplopia was present in 5 cases, which were resolved with surgical treatment in 3 of them. The eye with reduced vision was operated on in 37 patients, both eyes in 6 cases, and botulinum toxin was injected in 1 case. The final outcome was successful in 90.6% of the cases which were surgically treated. The mean follow up was 31.84 months.ConclusionsThere were twice as many exotropias as esotropias. Strabismus surgery of the amblyopic eye shows excellent results without the need of new operations. There were no new diplopia cases(AU)

[Postoperative recurrence of subdural empyema]. / Recidiva de empiema subdural postquirúrgico.

We present a case of recurrent subdural post-surgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a gram-positive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. However, it can cause infections, as in the central nervous system, especially post-surgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possibility of this organism, process the sample properly and keep touch with the Microbiology Department.

Management practices and their association with Mycobacterium tuberculosis complex prevalence in red deer populations in Southwestern Spain.

Intensification of game management may increase the prevalence of tuberculosis (TB) in wildlife despite eradication programs implemented in cattle herds in the same areas. In this cross-sectional study, we investigated the association between wild game management practices and the presence of tuberculosis in red deer populations in Southwestern Spain. Five hundred and fifty-one animals were examined by necropsy to detect tuberculosis-like lesions in the main lymph nodes. Prevalence, as determined by TB-like lesions, was estimated to be 5.1% of animals, with 77% of TB-like lesions confirmed by PCR. Our results suggest that population density, in addition to factors which promote the local aggregation of animals, is factors associated with increased prevalence of TB in red deer populations. We suggest that management practices including supplementary feeding, fencing, water ponds and interaction with domestic livestock should be revised in order to prevent TB in wild deer both.

Recidiva de empiema subdural postquirúrgico / Postoperative recurrence of subdural empyema

Se presenta un caso de recidiva de infección postquirúrgica en forma de empiema subdural por Proprionibacterium acnes tras un primer empiemadrenado en el que no se llegó al diagnóstico microbiológico. P acnes es un microorganismo gram positivo, anaerobio, que forma parte de la flora saprófita de la piel y de otras zonas del organismo. Sin embargo puede producir infecciones, entre otras localizaciones, en el sistema nervioso central (SNC), especialmente infecciones postquirúrgicas en las que puede llegar a ser el segundo germen en frecuencia después de Staphylococcusaureus. Es de crecimiento lento y suele crecer mejor en medios anaeróbicos líquidos. Suele ser resistente almetronidazol y sensible a penicilinas. En las infecciones postquirúrgicas del sistema nervioso central hay que tener en cuenta la posibilidad de este microorganismo, procesar las muestras de forma adecuada y mantenernos en contacto con el Servicio de Microbiología (AU)

We present a case of recurrent subdural postsurgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a grampositive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. However, it can cause infections, as in the central nervous system, especially postsurgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possi- bility of this organism, process the sample properly and keep touch with the Microbiology Department (AU)

Parents' genetic dissimilarity and offspring sex in a polygynous mammal.

Offspring quality may benefit from genetic dissimilarity between parents. However, genetic dissimilarity may trade-off with additive genetic benefits. We hypothesized that when sexual selection produces sex-specific selective scenarios, the relative benefits of additive genetic vs. dissimilarity may differ for sons and daughters. Here we study a sample of 666 red deer (Cervus elaphus) microsatellite genotypes, including males, females and their foetuses, from 20 wild populations in Spain (the main analyses are based on 241 different foetuses and 190 mother-foetus pairs). We found that parental lineages were more dissimilar in daughters than in sons. On average, every mother was less related to her mate than to the sample of fathers in the population when producing daughters not sons. Male foetuses conceived early in the rutting season were much more inbred than any other foetuses. These differences maintained through gestation length, ruling out intrauterine mortality as a cause for the results, and indicating that the potential mechanism producing the association between parents' dissimilarity and offspring sex should operate close to mating or conception time. Our findings highlight the relevance of considering the sex of offspring when studying genetic similarity between parents.

[Postsurgical meningitis. Differential characteristics of aseptic postsurgical meningitis]. / Meningitis postquirúrgica. Características diferenciales de la meningitis aséptica post-quirúrgica.

BACKGROUND: Postsurgical meningitis is a rare complication that is accompanied by an increase of hospital stay and high mortality. Some of these cases are not due to a true infection but due to an aseptic inflammation of the meninges denominated aseptic postsurgical meningitis (APSM). Proper identification of these cases would allow better use of antimicrobial drugs. METHODS: A retrospective study of patients with postsurgical meningitis in a universitary hospital for 14 years. We describe the clinical characteristics of patients with postsurgical bacterial meningitis (PBM) compared to those of patients with APSM. RESULTS: During the studied period 35 patients (71%) with PBM and 14 patients (29%) with (APSM) were identified. The mean age of patients with PBM was similar to that of patients with APSM. There was a male predominance in the group of PBM (71%) compared with patients with APSM (36%, p = 0.020). Patients with intracranial hemorrhage tended to present more cases of APSM (64%) than of PBM (34%, p = 0.055). Patients undergoing posterior fossa craniotomy (p = 0.092) and those receiving steroids (p = 0.051) showed a greater tendency to suffer APSM. It was also noted a trend towards present PBM in patients who had suffered an infection in the previous month (p = 0.072). There were seven patients with PBM (20%) with a cell count above 5000 cells/mm3 in CSF, values not found in any patients with APSM. No differences were detected in the glycorrachia and proteinorrachia between the two groups. The most common bacteria isolated were coagulase negative Staphylococcus and S. aureus. In 5 patients (14%) non fermenting gram-negative bacillus (Pseudomonas aeruginosa and Acinetobacter spp) were isolated. There were no deaths attributed to any type of postsurgical meningitis. CONCLUSION: Patients admitted for brain haemorrhage, undergoing posterior fossa surgery or receiving steroids tend to develop APSM. A CSF cell count above 5000 cells / mm3 strongly suggests MBP.

Meningitis postquirúrgica. Características diferenciales de la meningitis asépticapost-quirúrgica / Postsurgical meningitis. Differential characteristics of aseptic postsurgical meningitis

complicación infrecuente que se acompaña de unincremento de la estancia hospitalaria y de una elevadamortalidad. Algunos de estos casos no son debidos a unaverdadera infección sino a una inflamación aséptica delas meninges denominada meningitis aséptica post-quirúrgica(MAPQ). La adecuada identificación de estoscasos permitiría una mejor utilización de los fármacosantimicrobianos.Material y métodos. Estudio retrospectivo de lospacientes con meningitis postquirúrgica en un hospitalterciario durante 14 años comparando las característicasclínicas de los pacientes con meningitis bacterianapostquirúrgica (MBP) frente a las de pacientes conMAPQResultados. Durante el período analizado se identificaron35 pacientes (71%) con MBP y 14 pacientes (29%)con MAPQ. La edad media de los pacientes con MBPfue similar a la de los pacientes con MAPQ. Hubo predominiode varones en el grupo de MBP (71%) en relacióncon los pacientes con MAPQ (36%, p=0,020). Laproporción de pacientes con hemorragia intracranealtendió a ser más frecuente en pacientes que posteriormentedesarrollaron MAPQ (9 pacientes, 64 %) que enlos pacientes con MBP (12 casos, 34%, p=0,055). Lospacientes sometidos a craneotomía posterior (p=0,092)y los que recibían tratamiento esteroideo (p=0,051)mostraron una mayor tendencia a padecer MAPQ.Siete pacientes MBP (20%) presentaron un recuentocelular superior a 5000 células/mm3 en el LCR, cifrano encontrada en ningún caso de MAPQ. No se detectarondiferencias en la glucorraquia y proteinorraquiaentre ambos grupos. La bacterias más frecuentementeaisladas fueron Staphylococcus coagulasa negativa y S.aureus. En 5 pacientes (14%) se aislaron bacilos gramnegativosno fermentadores (Pseudomonas aeruginosa yAcinetobacter spp). No hubo ningún fallecimiento atribuidoa meningitis postquirúrgica. (..) (AU)

Background. Postsurgical meningitis is a rare complicationthat is accompanied by an increase of hospitalstay and high mortality. Some of these cases are not dueto a true infection but due to an aseptic inflammation ofthe meninges denominated aseptic postsurgical meningitis(APSM). Proper identification of these cases wouldallow better use of antimicrobial drugs.Methods. A retrospective study of patients withpostsurgical meningitis in a universitary hospital for14 years. We describe the clinical characteristics ofpatients with postsurgical bacterial meningitis (PBM)compared to those of patients with APSM.Results. During the studied period 35 patients (71%)with PBM and 14 patients (29%) with (APSM) wereidentified. The mean age of patients with PBM wassimilar to that of patients with APSM. There was a malepredominance in the group of PBM (71%) comparedwith patients with APSM (36%, p = 0.020). Patientswith intracranial hemorrhage tended to present morecases of APSM (64%) than of PBM (34%, p = 0.055).Patients undergoing posterior fossa craniotomy (p =0.092) and those receiving steroids (p = 0.051) showeda greater tendency to suffer APSM. It was also noted (...) (AU)

Polygyny can increase rather than decrease genetic diversity contributed by males relative to females: evidence from red deer.

Polygyny is expected to erode genetic variability by reducing the diversity of genetic contribution of males to the next generation, although empirical evidence shows that genetic variability in polygynous populations is not lost as rapidly as expected. We used microsatellite markers to study the genetic variability transmitted by mothers and fathers to offspring during a reproductive season in wild populations of a polygynous mammal, the red deer. Contrary to expectations, we found that males contributed more genetic diversity than females. Also, we compared study populations with different degrees of polygyny to find that polygyny was not related to a decrease in genetic diversity contributed by males. On the contrary, when population genetic diversity was relatively low, polygyny associated with higher genetic diversity of paternal lineage. Our results show that sexual selection, by favouring heterozygote individuals, may compensate the potential reduction of effective population size caused by polygyny, thus contributing to explain why genetic diversity is not depleted in polygynous systems.

Plasma mineral content in type-2 diabetic patients and their association with the metabolic syndrome.

BACKGROUND: Metabolic syndrome is a clinical disorder that is becoming more prevalent in Spain. The syndrome encompasses a set of metabolic disorders such as type-2 diabetes mellitus, hypertension, dyslipidemia, and obesity, which may be associated with variations in serum levels and poor delivery of certain mineral elements. METHODS: This study attempted to ascertain whether metabolic syndrome might be linked to alterations in serum levels of the mineral elements magnesium, copper, zinc, chromium, and nickel in a population of 92 diabetic subjects, some suffering from certain conditions associated with the metabolic syndrome, and 72 control subjects (Hospital Príncipe de Asturias, Alcalá de Henares, Spain). RESULTS: The results indicated that as a group the alterations implicated in metabolic syndrome were indeed associated with variations in blood levels of the mineral elements considered, though statistically significant differences were recorded only in the case of copper. Still, trends in mineral levels for each of the separate components contributing to the syndrome tended to increase. CONCLUSION: Metabolic complications appear to be associated with alterations in the levels of some minerals, especially copper.

Artritis reactiva secundaria a inmunoterapia intravesical con bacilo / Reactive arthritis secondary to intravesical

Presentamos un caso de artritis reactiva secundaria a inmunoterapia intravesical con bacilo de Calmette-Guerin (BCG) como tratamiento del cáncer de vejiga superficial. Esta complicación es muy infrecuente de modo que sólo ocurre en el 0,5% de los pacientes tratados. Aparece tardíamente, tras la cuarta o quinta instilación y afecta de forma asimétrica preferentemente a la rodilla, el tobillo y la muñeca. El tratamiento de elección son los antiinflamatorios no esteroideos (AINE)

We present a case of reactive arthritis secondary to intravesical bacillus Calmette-Guerin (BCG) immunotherapy as treatment of superficial bladder cancer. This complication is very rare as it only occurs in 0.5% of the patients treated. It appears late, after the fourth or fifth instillation and mainly affects the knee, ankle and wrist asymmetrically. Treatment of choice is non-steroid anti-inflammatory drugs (NSAIDs)