Recovery of the physiological status in professional basketball players using NESA neuromodulation treatment during different types of microcycles in season: A preliminary randomized clinical trial.

The purpose of the study was to describe and compare recovery status after official basketball competition in players who underwent NESA neuromodulation treatment (NNT) in weeks with one or two matches. The recovery parameters of 12 professional male basketball players (mean ± SD, age: 20.6 ± 2.7 yr; height: 197.8 ± 11.7 cm; and body mass: 89.0 ± 21.2 kg) that competed in the LEB Plata (Spanish third division) were monitored 2 days after match-play over 6 weeks, and included: 1) the Hooper Test, which combines four subjective variables (sleep, stress, fatigue and soreness); 2) common biochemical markers (e.g., testosterone, cortisol and ratio T:C); and 3) lowest heart rate [HR], average HR, HR variability, sleep duration, awake time during night and onset latency before asleep). Players that completed NNT presented differences compared to the control group in sleep data. For instance, the lowest HR (p < 0.001), average HR (p < 0.001) and total awake time (p = 0.04) were significantly reduced in the NNT group. On the contrary, the control group presented greater values than the NNT group in the subjective Hooper Test, although only stress presented significant differences (Control 2.5 ± 1.2 vs. NNT cost or 3.2 ± 0.9; p = 0.01). Additionally, there were no significant differences in recovery parameters between weeks with one or two matches. In conclusion, the results suggest that players that underwent NNT tended to improve their sleep quality. Nevertheless, player's values in the biochemical markers and wellness status remained similar in both groups. The fact that no significant differences were found between weeks with one or two matches could help basketball professionals to determine that a congested schedule does not seem to negatively alter recovery status. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04939181?term=NCT04939181, NCT04939181.

[Impact of family restrictions during COVID-19 pandemic on the use of physical restraint in an acute hospital: An observational study]. / Impacto de las restricciones de visitas de familiares de pacientes por la pandemia de COVID-19 sobre la utilización de la contención mecánica en un hospital de agudos: estudio observacional.

INTRODUCTION: During the worldwide pandemic of COVID-19 caused by coronavirus SARS-CoV-2, hospitals developed contingency plans that transformed and reorganized the hospital activity. One of the measures was to restrict access to family members of hospitalized patients. The presence of the patient's family is considered an alternative to physical restraint. The aim of this study is to compare the use of physical restraint in hospitalized patients in an acute care hospital during the previous period of the pandemic of COVID-19 with the post-confinement period with hospitals being still closed to family. MATERIAL AND METHODS: We made an observational study that compares the prevalence of physical restraint in an acute care hospital during the previous period to the alarm state (February 2020) with the second period, when visits where restricted (May 2020). From the clinical history of the patients with physical restraint we collected the following variables: sex, diagnostic, hospital admission unit, reason for using physical restraint, localization, length, type of material, registration in the medical record, information given to the family, alternatives to the physical restraint and injuries related to the physical restraint. RESULTS: We evaluated 690 patients: 388 during the previous period and 320 during the second period. From all patients, 29 needed physical restraint. The use of physical restraint went from 8 (2%) to 21 (7%) (p=0.003). In the second period, a not statistically significant increase in continuous physical restraint was identified compared to the first period. CONCLUSIONS: The physical restraint prevalence has been superior during the second period in which families were not present with the hospitalized patients.

Pollutant emissions during the pyrolysis and combustion of starch/poly(vinyl alcohol) biodegradable films.

The massive use of petroleum-based polymers and their improper waste treatment has brought on significant global environmental problems due to their non-biodegradable nature. Starch/poly(vinyl alcohol) (PVA) bioplastics are suitable substitutes for conventional polymers, such as polyethylene, due to their full biodegradability and excellent mechanical properties. Knowledge of the pollutant emissions during pyrolysis and combustion of starch/PVA films is important because they can arrive at landfills mixed with conventional polymers and be thermally degraded in uncontrolled fires. On the other hand, controlled thermal treatments could result in thermal valorization of the waste. Pyrolysis and combustion experiments were carried out at 650, 750, 850 and 950 °C in a laboratory furnace. The analysis of carbon oxides, light hydrocarbons, and semivolatile compounds, including polycyclic aromatic hydrocarbons (PAHs), is shown. Experiments showed lower pollutant emissions than those found with conventional polymers, such as polyethylene and polyester, in the same equipment. Nevertheless, the pyrolysis run at 950 °C showed the highest light hydrocarbon yield (123013 mg kg-1), but this is considerably lower than the values found for polyethylene. The main semivolatile compounds (not PAHs) emitted, with maximum yields ranging from 1351 to 4694 mg kg-1, were benzaldehyde, phenol, indene, and acetophenone. Specifically, the total semivolatile compounds emitted after pyrolysis and combustion of starch/PVA samples represent only 38 and 50%, respectively, of those emitted with polyethylene. Further, the main PAHs were naphthalene, acenaphthylene, and phenanthrene with maximum values of 4694, 2704 and 1496 mg kg-1, respectively. The PAH yield was considerably higher in experiments with low oxygen content.

Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry?

BACKGROUND: Preoperative oral capecitabine plus radiotherapy has been progressively adopted in oncology units to provide more convenient care to patients with rectal cancer, but little is known about adherence to this therapy. PATIENTS AND METHODS: Prospective, multicentre observational study in six hospitals in metropolitan Barcelona (Spain), in patients with stage II and III rectal cancer. Assessment of adherence was based on the medical report in the clinical history, a patient questionnaire and a pill count in the pharmacy service upon finalization of treatment. Patients were considered adherent if they had taken 80%-110% of the prescribed treatment. We evaluated clinical variables, adverse effects, anxiety and depression (using the hospital anxiety depression scale [HADS]), and quality of life (EORTC QLQ-30). We analysed adherence-associated variables using a logistic regression model and concordance between adherence measures by means of the modified Kappa index. RESULTS: We included 119 participants. Adherence measures showed little concordance between the assessment methods used: adherence was 100% according to the clinical history, 83.2% according to self-report and 67.9% according to the pill count. In the multivariable analysis, the most relevant variable associated with non-adherence was anxiety prior to treatment (adjusted odds ratio [ORa] 6.96, 95% confidence interval [CI] 1.48-32.7). We did not observe any relevant association between adherence and clinical variables and baseline quality of life parameters. CONCLUSIONS: Adherence to short-term oral neoadjuvant treatment in rectal cancer may be a clinical problem, and it should be acknowledged and systematically evaluated by clinicians during treatment. The limited concordance between different measures of adherence highlights the challenges in monitoring it and the need to use different approaches to assess its impact in clinical practice.

[MALLEOLAR ULCERS ASSOCIATED TO HYDROXYUREA TREATMENT]. / Úlceras maleolares asociadas al tratamiento con hidroxiurea.

INTRODUCTION: Hydroxyurea (HU) is an antineoplastic drug used in chronic myeloproliferative disorders. In this article we will go into detail about the rare but serious appearance of lower limb ulcers in relation to HU treatment. METHODOLOGY: Two simultaneous cases are presented, both from patients with lower limb torpid lesions unresponsive to conventional treatments. After dismissing other aetiologies, HU was found to be the causal agent in both cases. DISCUSSION: In spite of HU's known correlation to lower limb ulcers, pathogenesis isn't clearly defined. In this article we add two more cases to the existing bibliography, with the goal of both insisting on the importance of integral valuation of patients with ulcers and contemplating dermatologic screening on patients treated with HU. CONCLUSION: HU laden ulcers are usually underdiagnosed. Integral valuation and dermatologic screening on patients are critical.

The effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness after 3-month follow-up: CAPiCOR randomized clinical trial.

BACKGROUND: The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness. METHODS: We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose). RESULTS: The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P=0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P=0.086). However, the BMI decreased significantly more in the CG, by 0.26kg/m(2) (95%CI: 0.02 to 0.51; P=0.038), than in the IG. There were no significant differences in the WC. CONCLUSIONS: The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters. TRIAL REGISTRATION: Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).

Chemical characterization of emissions from a municipal solid waste treatment plant.

Gaseous emissions are an important problem in municipal solid waste (MSW) treatment plants. The sources points of emissions considered in the present work are: fresh compost, mature compost, landfill leaks and leachate ponds. Hydrogen sulphide, ammonia and volatile organic compounds (VOCs) were analysed in the emissions from these sources. Hydrogen sulphide and ammonia were important contributors to the total emission volume. Landfill leaks are significant source points of emissions of H2S; the average concentration of H2S in biogas from the landfill leaks is around 1700 ppmv. The fresh composting site was also an important contributor of H2S to the total emission volume; its concentration varied between 3.2 and 1.7 ppmv and a decrease with time was observed. The mature composting site showed a reduction of H2S concentration (<0.1 ppmv). Leachate pond showed a low concentration of H2S (in order of ppbv). Regarding NH3, composting sites and landfill leaks are notable source points of emissions (composting sites varied around 30-600 ppmv; biogas from landfill leaks varied from 160 to 640 ppmv). Regarding VOCs, the main compounds were: limonene, p-cymene, pinene, cyclohexane, reaching concentrations around 0.2-4.3 ppmv. H2S/NH3, limonene/p-cymene, limonene/cyclohexane ratios can be useful for analysing and identifying the emission sources.

PCDD/F emissions from light-duty diesel vehicles operated under highway conditions and a diesel-engine based power generator.

PCDD/F emissions from three light-duty diesel vehicles--two vans and a passenger car--have been measured in on-road conditions. We propose a new methodology for small vehicles: a sample of exhaust gas is collected by means of equipment based on United States Environmental Protection Agency (U.S. EPA) method 23 A for stationary stack emissions. The concentrations of O2, CO, CO2, NO, NO2 and SO2 have also been measured. Six tests were carried out at 90-100 km/h on a route 100 km long. Two additional tests were done during the first 10 min and the following 60 min of the run to assess the effect of the engine temperature on PCDD/F emissions. The emission factors obtained for the vans varied from 1800 to 8400 pg I-TEQ/Nm(3) for a 2004 model year van and 490-580 pg I-TEQ/Nm(3) for a 2006 model year van. Regarding the passenger car, one run was done in the presence of a catalyst and another without, obtaining emission factors (330-880 pg I-TEQ/Nm(3)) comparable to those of the modern van. Two other tests were carried out on a power generator leading to emission factors ranging from 31 to 78 pg I-TEQ/Nm(3). All the results are discussed and compared with literature.

PCDD/F formation from chlorophenols by lignin and manganese peroxidases.

Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/F) formation was studied, in vitro, with two different chlorophenol mixtures (group "di+tri" 2,4-dichlorophenol; 2,3,4-, 2,3,5-, and 3,4,5-trichlorophenols and group "tri+tetra+penta" with 2,4,5-trichlorophenol, 2,3,4,6-tetrachlorophenol and pentachlorophenol) and two different lignolytic enzymes, lignin and manganese peroxidase (LiP and MnP respectively), which can be found during the composting process of sewage sludge. The concentrations of PCDD/F in final samples are compared to the PCDD/F content of the control samples containing the chlorophenols. High increases were observed for experiments with MnP and phosphate buffer. Experiments that contained tri-, tetra- and pentachlorophenol with MnP resulted in more than 8·10(8)ng of OCDD kg(-1) chlorophenol which was much higher than the initial amount (1·10(7)ng OCDD kg(-1) chlorophenol). In relation to LiP experiments, only those at 37°C showed a moderate increase (from 1.3·10(7) to 2.6·10(7)ng of OCDD kg(-1) chlorophenol). The results agree with the literature in which high amounts of HpCDD and OCDD were found after a composting process and could explain the biogenic formation suggested by others, but the incidence on the total toxicity is less than that expected.

PCDD/F and dioxin-like PCB concentrations during municipal solid waste biomethanation and subsequent composting.

PCDD/F and dioxin-like PCB concentrations were compared in different samples of a municipal solid waste (MSW) treatment plant: the initial MSW fraction that enters the biomethanation from the digester, the semi-solid digestate obtained after biomethanation of MSW, and the solids after composting the digestate since the final product is destined for land application and special attention must be paid to these compounds for environmental considerations. The initial MSW sample showed low concentrations of PCDD/Fs, although in the biomethanation output sample the concentration was more than ten times higher. The difference was even more significant for PCBs. In compost samples concentrations for both PCDD/Fs and PCBs were in the same range as in biomethanation or lower. Nevertheless, concentrations found for all samples were low and these treatments do not pose a major problem for the environment in the working conditions used.

[Patellar osteochondral injury as onset of patellar instability]. / Lesión osteocondral patelar como debut de una inestabilidad rotuliana.

Patellar osteochondral fractures with no dislocation are uncommon and usually affect the centromedial facet of the patella. We present the case of a 10 year-old, overweight, female patient. She was seen in the emergency room after suffering an accidental fall, assessed as an osteochondral fracture-dislocation of the right patella with upper-outer displaced free fragments. By patient interview, she referred to no previous episodes of patellar dislocation. To complete the study, we performed an MRI which showed a medial facet patellar fracture, with two osteochondral fragments located in the sub-quadricipital recess, associated with other lesions suggesting patellar subluxation. We considered that the best treatment was surgery, so the following was performed: an open reduction and internal fixation with absorbable bars, lateral patellar release (Ficat technique), patellar coverage by medial portion of quadriceps (Insall technique) and internal moving of the lateral half of the patellar tendon (Goldwaith technique). The injury was checked one year later using arthroscopy. It confirmed a good reconstruction of the articular surface, and right patellar centering. At follow-up, during the physiotherapy period, the patient began to have repeated episodes of instability in the contralateral patella. The CT scan confirmed the patellar lateralisation (TAGT 17). Centering surgery was indicated due to the occurrence of multiple dislocation episodes. The patient currently carries out normal physical activity and she has a complete range of movement. Patellar osteochondral fracture is an injury frequently associated with patellar instability, which may onset in the first episode. The medial location of the lesions and the involvement of the system of medial knee stability is a fundamental finding. This fact reinforces the diagnosis of pre-fracture patellar dislocation. This is not a fracture-dislocation, but a dislocation-fracture. We may, therefore, treat the injury and its cause.

Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain.

AIMS: To compare different methods in order to assess adherence and persistence with oral endocrine therapy in women diagnosed with breast cancer (BC) in Catalonia. MATERIALS AND METHODS: This study covered all women newly diagnosed with stage I, II or IIIa BC and positive hormone receptors at six hospitals in Catalonia (Spain) in 2004. Adherence was assessed on the basis of physician report and patient self-report using a telephone questionnaire. Persistence was measured by refill prescriptions. We used the Kappa index to compare adherence measures and logistic regression to evaluate adherence-related risk factors. RESULTS: The study covered a total of 692 women. Adherence ranged from 92% (self-report) to 94.7% (physician report), depending on the measure used; persistence was 74.7% at 5 years of follow-up. Low concordance between measures was observed (Kappa range: 0.018-0.267). Patients aged 50-74 years showed higher adherence than those aged <50 years. Adherence was also associated with: adjuvant chemotherapy and sequential hormonal therapy. CONCLUSIONS: Concordance between the different measures was remarkably low, indicating the need for further research. Adherence is an issue in the management of BC patients taking oral drugs, and should be assessed in clinical practice.

Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review).

Multifocal epithelial hyperplasia (MEH), also known as Heck's disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported.

Potential of Spanish sour-sweet pomegranates (cultivar C25) for the juice industry.

Commercial juices of sweet pomegranates and fresh juices of sour-sweet pomegranates were analysed for organic acids, sugars, antioxidant activity, volatile composition, sensory profile and consumer liking. Organic acids and sugars were analysed by high-performance liquid chromatography, while volatiles were extracted using hydrodistillation and analysed by gas chromatography-mass spectrometry and gas chromatography-flame ionisation detector. Malic acid was predominant in sweet juices while citric acid in sour-sweet samples. Fructose and glucose were found as the predominant sugars in all juices. A total of 18 compounds were found in pomegranate aroma profile, including monoterpenes, aldehydes, alcohols, monoterpenoids and linear hydrocarbons; the most abundant compounds were 3-carene, α-terpinene and α-terpineol. The total concentration of volatiles ranged from 2.0 up to 5.1 mg/L, with commercial samples presenting higher total concentrations due to the presence of peel volatiles. The high potential of sour-sweet pomegranate fruits for the juice industry was supported by (a) the high values of positive attributes, such as colour and fresh pomegranate flavour and (b) the high overall liking of consumers.

In vivo biological activity of rocket extracts (Eruca vesicaria subsp. sativa (Miller) Thell) and sulforaphane.

Eruca is thought to be an excellent source of antioxidants like phenolic compounds, carotenoids, glucosinolates and their degradation products, such as isothiocyanates. Sulforaphane is one of the most potent indirect antioxidants of Eruca isolated until the date. In this work we investigate: (i) the safety and DNA protective activity of Eruca extracts and sulforaphane (under and without oxidative stress) in Drosophila melanogaster; and (ii) the influence on D. melanogaster life span treated with Eruca extracts and sulforaphane. Our results showed that among the four concentrations of Eruca extracts tested (from 0.625 to 5mg/ml), intermediate concentrations of the Es2 accession (1.25 and 2.5mg/ml) exhibited no genotoxic activity, as well as antigenotoxic activity (inhibition rate of 0.2-0.6) and the lowest concentration of Es2 and Es4 accessions (0.625 mg/ml) also enhanced the health span portion of the live span curves. Sulforaphane presented a high antigenotoxic activity in the SMART test of D. melanogaster and intermediate concentrations of this compound (3.75 µM) enhanced average healthspan. The results of this study indicate the presence of potent antigenotoxic factors in rocket, which are being explored further for their mechanism of action.

Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards.

Improvement in hand hygiene (HH) compliance has been associated with a decrease in the incidence of hospital-acquired infection (HAI) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infection/colonization. We aimed to evaluate the impact of a multimodal intervention in medical wards on HH compliance, alcohol-based hand rub (AHR) consumption and incidence of HAI and HA-MRSA. A before-after intervention study and an assessment 1 year later were conducted in three internal medicine wards. HH compliance during routine patient care was monitored using the WHO HH observation method. AHR consumption was registered. HAI incidence was actively sought during the PRE and POST periods. HAI risk factors were prospectively recorded and incidence density was calculated. A total of 825 patients were prospectively followed in the PRE period and 868 patients in the POST period. We observed 1531 opportunities for HH in PRE and POST periods and 450 1 year later. HH compliance improved from 54.3% to 75.8% (p 0.005) and remained 75.8% at follow-up. AHR consumption increased from 10.5 to 27.2 L/1000 hospital-days and 31.5 L/1000 hospital-days at follow-up. Incidence density of HAI was 6.93 and 6.96/1000 hospital-days in the PRE and POST intervention periods, respectively. HA-MRSA incidence density was 0.92 in the PRE period vs. 0.25/1000 hospital-days in the POST period (p 0.2) and 0.15/1000 hospital-days (p 0.1) 1 year later. A sustained increase in AHR consumption was followed by an improvement in HH compliance after a multimodal campaign. A trend for lower incidence density of new hospital-acquired MRSA was detected in the POST intervention and follow-up periods.

Thermogravimetric kinetic analysis and pollutant evolution during the pyrolysis and combustion of mobile phone case.

The increase in electronic waste, including cellular telephones, worldwide is a worrying reality. For this reason, urgent action on the management of these wastes is necessary within a framework that respects the environment and human health. Mobile phone components can be physically segregated through grinding at the dismantling sites, in order to reuse or reprocess (via chemical or physical recycling) the recovered plastics and valuable metals. A kinetic study of the thermal decomposition of a mobile phone case has been carried out under different conditions by thermogravimetry. Several experiments were performed in a nitrogen atmosphere (pyrolysis runs) and also in an oxidative atmosphere with two different oxygen concentrations (10% and 20% oxygen in nitrogen). Dynamic runs and dynamic+isothermal runs have been carried out to obtain much decomposition data under different operating conditions. Moreover some TG-MS runs were performed in order to better understand the thermal decomposition of a mobile phone case and identify some compounds emitted during the controlled heating of this material. A scheme of two independent reactions for pseudocomponents has been proposed for the pyrolysis process. For the combustion runs, the scheme proposed includes two pyrolytic reactions competing with other two reactions with formation of an intermediate residue, and finally the reaction of oxidation/burning of the intermediate residue. Furthermore, pyrolysis and combustion runs at 500 °C in a horizontal laboratory furnace were carried out. More than 50 compounds, including carbon oxides, light hydrocarbons, and polycyclic aromatic hydrocarbons (PAHs) have been identified and quantified. The main semivolatile compounds detected were phenol and styrene. Furthermore, polychlorodibenzo-p-dioxin and polychlorodibenzofurans (PCDD/Fs) and dioxin-like PCBs produced were analyzed. In the combustion run, PCDDs were obtained in higher amounts than PCDFs and HxCDD was the most emitted homologue.

Implementing a Cancer Fast-track Programme between primary and specialised care in Catalonia (Spain): a mixed methods study.

BACKGROUND: The Cancer Fast-track Programme's aim was to reduce the time that elapsed between well-founded suspicion of breast, colorectal and lung cancer and the start of initial treatment in Catalonia (Spain). We sought to analyse its implementation and overall effectiveness. METHODS: A quantitative analysis of the programme was performed using data generated by the hospitals on the basis of seven fast-track monitoring indicators for the period 2006-2009. In addition, we conducted a qualitative study, based on 83 semistructured interviews with primary and specialised health professionals and health administrators, to obtain their perception of the programme's implementation. RESULTS: About half of all new patients with breast, lung or colorectal cancer were diagnosed via the fast track, though the cancer detection rate declined across the period. Mean time from detection of suspected cancer in primary care to start of initial treatment was 32 days for breast, 30 for colorectal and 37 for lung cancer (2009). Professionals associated with the implementation of the programme showed that general practitioners faced with suspicion of cancer had changed their conduct with the aim of preventing lags. Furthermore, hospitals were found to have pursued three specific implementation strategies (top-down, consensus-based and participatory), which made for the cohesion and sustainability of the circuits. CONCLUSION: The programme has contributed to speeding up diagnostic assessment and treatment of patients with suspicion of cancer, and to clarifying the patient pathway between primary and specialised care.

[Giant optic disk melanocytoma complicated with massive intraocular seeding]. / Melanocitoma gigante de la papila óptica complicado con siembra intraocular masiva.

CASE REPORT: A 33 year-old female with a large, unilateral, dark tumour of the optic disk with a presumed diagnosis of melanocytoma. After a follow-up of nineteen years, the tumour produced massive intraocular seeding with cataract, secondary glaucoma (pigmentary, melanocytomalytic, inflammatory and pupillary seclusion glaucoma) and amaurosis. The eye is enucleated and the pathological examination confirmed the diagnosis. DISCUSSION: Optic disk melanocytoma is a benign stationary tumour. However, sometimes that are to complications, including visual loss. Our case confirms that vitreous seeding is due to tumour necrosis with dissemination of tumoral debris and melanin, which are phagocytized by macrophages and produce an inflammatory reaction, trabecular plugging and ocular hypertension.