Strontium and oxygen isotopes to trace mobility routes during the Bell Beaker period in the north of Spain.

Strontium and oxygen isotopes of individuals from El Hundido and Valdescusa (north of Spain) sites, corresponding to the Bell Beaker culture, were analysed in order to determine mobility patterns and provenance areas. Strontium and oxygen isotope ratios in three teeth from two individuals at El Hundido and two teeth from the five individuals at Valdescusa were studied. The analyses were performed in both dentine and enamel fractions. 87Sr/86Sr ratios of El Hundido individuals indicate one was of foreign origin and the other was local whereas at Valdescusa were all of foreign provenance. Calculated δ18Ow values of El Hundido suggest a provenance from the geographical area close to the site while the Valdescusa would come from a warmer region. The comparison of oxygen and strontium isotope signatures indicate the west of the Iberian Peninsula (Zamora or the east of Leon regions) as the provenance area for the foreign individual at El Hundido and southwest France (Garonne basin) as the region of provenance for the Valdescusa.

Skeletal Muscle Mass by Bioelectrical Impedance Analysis and Calf Circumference for Sarcopenia Diagnosis.

Skeletal muscle mass (SMM) plays an important role in health and physical performance. Its estimation is critical for the early detection of sarcopenia, a disease with high prevalence and high health costs. While multiple methods exist for estimating this body component, anthropometry and bioelectrical impedance analysis (BIA) are the most widely available in low- to middle-income countries. This study aimed to determine the correlation between muscle mass, estimated by anthropometry through measurement of calf circumference (CC) and skeletal mass index (SMI) by BIA. This was a cross-sectional and observational study that included 213 functional adults over 65 years of age living in the community. Measurements of height, weight, CC, and SMM estimated by BIA were made after the informed consent was signed. 124 women mean age 69.6 ± 3.1 years and 86 men mean age 69.5 ± 2.9 years had the complete data and were included in the analysis. A significant positive moderate correlation among CC and SMI measured by BIA was found (Pearson r= 0.57 and 0.60 for women and men respectively (p=0.0001)). A moderate significant correlation was found between the estimation of SMM by CC and by BIA. This suggests that CC could be used as a marker of sarcopenia for older adults in settings in lower-middle-income countries where no other methods of diagnosing muscle mass are available. Although the CC is not the unique parameter to the diagnosis of sarcopenia, it could be a useful procedure in the clinic to identify patients at risk of sarcopenia.

[Metachronous contralateral Leydig cell tumor of the testis: conservative treatment]. / Tumor testicular de células de Leydig contralateral metacrónico: tratamiento conservador.

Leydig cell tumors are the primary nongerm cell tumors of the testis, comprising approximately 1 to 3% of all testicular neoplasms. These tumors are bilateral in 5 to 10% of cases. Hypoechoic testicular nodule associated to a child virilising syndrome or adult gynecomastia with negative testis tumor markers (AFP, B-HCG) show a high index suspicion for this entity. We report a case of metachronous contralateral Leydig cell tumor in a 32 years old man with a 9 year interval between presentations, in which we performed local excision of the lesion. Diagnostic an therapeutic aspects are reviewed in literature. Since preoperative diagnosis of Leydig cell tumors in difficult and clinical course unpredictible, radical orchiectomy has been the standard treatment. Emphasis is made on conservative management opportunity in patients with only one testis, small tumors (less than 2.5 cm) with biopsies from tumor bed negative and wishes to remain fertile and/or refuses androgen supplementation. Follow-up is mandatory by performing scrotal ultrasounds. CT scan, Chest X-Ray, tumor markers and hormone determinations (testosterone, estradiol, progesterone, LH and FSH).

[Large renal leiomyoma]. / Leiomioma renal voluminoso.

Renal leiomyomas are uncommon between renal tumors, and they have a benign mesenchymatous origin. Because of their low incidence, unspecific symptomatology an not well-defined iconographic semiology, they often raise problems with differential diagnosis from kidney masses, although they are often big size lessions. We report a patients with incidentally diagnosis of big solid left renal mass, who underwent radical nephrectomy resulting kidney pelvis leiomyoma. Diagnostic, histological and therapeutic aspects are briefly review in literature. Emphasis is made on the relevance of a high index suspicion considering big solid asymptomatic renal masses in middle-age women. Specially in renal tumors with well-defined limits and abscence of locoregional and systemic dissemination. We emphasized usefulness of Magnetic Angioresonance, immunohystochemical test and conservative surgery opportunity in small renal leiomyomas preoperatively confirmed.

[Synchronous association of Bellini collecting ducts and pyelic transitional cell carcinoma]. / Asociación sincrónica de carcinoma de los conductos colectores de Bellini y carcinoma transicional pielico.

Bellini's collecting ducts carcinoma represent a subgroup within renal carcinoma with an incidence of 0.4 to 2% of all renal tumours. The collecting ducts share their embryological origin in Wölf's duct with the calices, renal pelvis and ureter. This common embryological origin could justify the association of carcinoma originated in the collecting ducts with transitional urothelial carcinoma. This paper contributes two patients with Bellini's collecting ducts carcinoma associated to "in situ" carcinoma and transitional papillar carcinoma in the adjacent renal pelvis respectively. The authors review the diagnostic, pathoanatomical and therapeutical aspects found in the literature. A high index of suspicion is required to diagnose a case of Bellini's carcinoma in the face of predominantly central-medullar renal solid lesions, with infiltrating growth that causes morphological changes in the excretory system without deforming the external renal outline. The authors highlight the value of immunohistochemical studies to reach a diagnosis, considering the natural history and the sombre prognosis of this uncommon renal neoplasia.