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"apellidos" => "Morchón" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417300592" "doi" => "10.1016/j.oftale.2017.03.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300592?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116301319?idApp=UINPBA00004N" "url" => "/03656691/0000009200000009/v1_201708280004/S0365669116301319/v1_201708280004/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579417300798" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.019" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1164" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:442-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Topical interferon alpha-2B topic as the first therapeutic option in a clinical case of conjunctival intraepithelial neoplasia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "442" "paginaFinal" => "446" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Interferón alfa-2B tópico como primera opción terapéutica en un caso clínico de neoplasia intraepitelial córneo-conjuntival" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 742 "Ancho" => 990 "Tamanyo" => 82350 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Biomicroscopy one-week after treatment, showing discrete corneal opacification reduction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Pagán Carrasco, D. Arranz Maestro" "autores" => array:2 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Pagán Carrasco" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Arranz Maestro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117300588" "doi" => "10.1016/j.oftal.2017.01.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117300588?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300798?idApp=UINPBA00004N" "url" => "/21735794/0000009200000009/v2_201708291316/S2173579417300798/v2_201708291316/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417300786" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.018" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1058" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:436-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "PDF" => 1 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Unilateral corneal edema caused by a hidden foreign body" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "436" "paginaFinal" => "438" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Edema corneal unilateral causado por un cuerpo extraño oculto" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 838 "Ancho" => 2998 "Tamanyo" => 196752 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">(A and B) Foreign body in right eye anterior chamber angle, with adjacent anterior synechia. (C) The foreign body was surgically extracted through inferior sclerocorneal incision.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Galvis, A. Tello, G.A. Frederick, A.N. Laiton" "autores" => array:4 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Galvis" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Tello" ] 2 => array:2 [ "nombre" => "G.A." "apellidos" => "Frederick" ] 3 => array:2 [ "nombre" => "A.N." "apellidos" => "Laiton" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S036566911630096X" "doi" => "10.1016/j.oftal.2016.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566911630096X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300786?idApp=UINPBA00004N" "url" => "/21735794/0000009200000009/v2_201708291316/S2173579417300786/v2_201708291316/en/main.assets" ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Human dirofilariasis in the eyelid caused by <span class="elsevierStyleItalic">Dirofilaria repens</span>: An imported case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "439" "paginaFinal" => "441" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Rodríguez-Calzadilla, M.W. Ruíz-Benítez, J.L. de-Francisco-Ramírez, A.R. Redondo-Campos, E. Fernández-Repeto-Nuche, T. Gárate, R. Morchón" "autores" => array:7 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Rodríguez-Calzadilla" "email" => array:1 [ 0 => "mario_rodcal@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.W." "apellidos" => "Ruíz-Benítez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.L." "apellidos" => "de-Francisco-Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "A.R." "apellidos" => "Redondo-Campos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "E." "apellidos" => "Fernández-Repeto-Nuche" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "T." "apellidos" => "Gárate" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "R." "apellidos" => "Morchón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Oftalmología, Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Microbiología, Hospital de Jerez, Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Parasitología, Instituto de Salud Carlos III, Centro Nacional de Microbiología, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0020" ] 3 => array:3 [ "entidad" => "Departamento de Parasitología, Universidad de Salamanca, Salamanca, Spain" "etiqueta" => "d" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dirofilariasis palpebral causada por <span class="elsevierStyleItalic">Dirofilaria repens:</span> un caso importado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 810 "Ancho" => 950 "Tamanyo" => 71357 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Eyeled at diagnostic.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Dirofilaria</span> nematodes utilize different wildlife or domestic animal species as a host, with dogs (<span class="elsevierStyleItalic">Canis lupus familiaris</span>) being the most relevant. In infected individuals, the parasite is transmitted with the participation of several mosquito genders who act as vectors.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Even though humans are accidental hosts in the biological cycle of the parasite, the literature comprises reports of dirofilariasis in multiple regions of the world. The most frequently isolated species in Europe is <span class="elsevierStyleItalic">D. repens</span>.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Even though a broad range of anatomical locations have been reported, generally <span class="elsevierStyleItalic">D. repens</span> infection presents through subcutaneous or subconjunctival nodules.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2–10</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinic case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">In June 2015, a 33-year-old Ukrainian female residing in Spain during 4 years visited the emergency practice referring the existence of a worm under the skin of the upper left eyelid that apparently moved during the night and “bit her”. A complete ophthalmological examination revealed a subcutaneous lesion associated to slight edema and vascular congestion that actually presented a wormlike appearance that appeared to crawl under the skin (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The foreign body was surgically removed the same day, producing an unidentified living parasite measuring 1<span class="elsevierStyleHsp" style=""></span>mm diameter and approximately 10<span class="elsevierStyleHsp" style=""></span>cm long that curled up around the surgical material (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The specimen was sent live to the Microbiology Dept. of the authors hospital for subsequent transport to the national parasitology reference centers. The patient expressed anxiety about the possible presence of pathogenes in other parts of her body, for which reason a peripheral blood sample was taken that discarded the existence of microfilaremia (immature forms of the parasite in blood). After receiving the results of the microbiological study and the microbiology report identified the parasite through PCR as a specimen of <span class="elsevierStyleItalic">D. repens</span>, curative surgery was considered and the need of new diagnostic or therapeutic actions was discarded.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,9</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">When lodging in the natural hosts, <span class="elsevierStyleItalic">D. repens</span> specimens reach sexual maturity and become able to release microfilariae into the bloodstream. These immature forms of the parasite circulate in the bloodstream until ingested by mosquitoes feeding off the host. In the organism of the vector they continue their development to become larvae that will be inoculated when biting a new host. At that point they become individual adult parasites that produce microfilaria and repeat the cycle. Humans become accidental hosts in the biological cycle of the parasite because in human tissue these larvae are unable to achieve sexually mature forms for releasing microfilaria. Only exceptionally microfilaremia has been described in humans, and this is the reason why the person–vector–person transmission is regarded as virtually impossible and also the reason why the surgical removal of the specimen (usually only one) is curative.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Pharmacological therapy is contraindicated in humans and surgery is not always necessary. A conservative approach is an option when the anatomical location of the lesion is an obstacle for surgery and involve sensitive tissue that can be damaged by the worm or the immune reaction against it. However, in some situations such as adult filariae inside the eye or even in the optic nerve, surgery is required despite its complexity and inherent risks. These situations have given rise to research on new therapeutic targets against various species of <span class="elsevierStyleItalic">Dirofilaria</span>. Research focused on the eradication of the <span class="elsevierStyleItalic">Wolbachia</span> bacteria is particularly promising because, as it acts symbiotically with the internal flora of the parasite, it is essential for its survival. Additional trials are needed to confirm the efficacy of this treatment and, if any pharmacological treatment must be applied, tetracyclines are recommended, particularly doxycycline.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">There is no doubt that <span class="elsevierStyleItalic">D. repens</span> is an emerging infectious agent. Despite being endemic in the Mediterranean coast, it is rare in humans, particularly in Spain where only 8 cases have been recorded against 35 of Greece, 87 of friends and 323 of Italy. However, in the past decade a significant increase of infection in humans has been observed, together with an increase in the prevalence of infection in animal hosts. Similarly, countries at higher latitudes in Central, Northern and Eastern Europe where traditionally said zoonosis hardly existed have experienced a dramatic increase of cases in animals as well as in humans. Several authors have related this with a clear expansion of the habitat of vectors and increased survival thereof due to the already demonstrated global warming<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>. In the past decades, climate change has facilitated the expansion of various mosquito genders into cold territories where proliferation was difficult and scarce in the past. Therefore, dirofilariasis was absent.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> There are multiple reports on the increase of said zoonosis in the regions mentioned above.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2–9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">A peculiarity of the case reported herein is the fact that the patient who came to Spain from one of said territories denied any interaction with animals in Spain but admitted close contact with dogs not subject to prophylaxis during her frequent visits to her country. Accordingly, although it is not possible to completely discard the possibility that the infection was acquired on Spanish territory, due to the low presence of said zoonosis in Spain and considering the increased expansion of dirofilariasis in Ukraine, leads to suspect that the pathogen inoculation could have occurred in that country. Therefore, it is likely that this worm was “returned” by a country that presumably received Mediterranean mosquitoes bearing the pathogen in the past decade in the context of climate change. This implies that we are likely witnessing an inversion in the endemic dirofilariasis regions in Europe as the global warming has extended the parasite to regions which were formerly beyond its natural habitat and, due to lower awareness, less veterinary prophylaxis in hosts and less control of population of vectors, the prevalence of the infection in animal hosts and therefore in humans has equaled or exceeded that of countries in which the endemic nature of said parasite is standard.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0035" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres888079" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec874021" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres888078" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec874020" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:2 [ "identificador" => "xack297018" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-06-15" "fechaAceptado" => "2016-07-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec874021" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Dirofilaria</span>" 1 => "<span class="elsevierStyleItalic">Dirofilaria repens</span>" 2 => "Human dirofilariasis" 3 => "Ophthalmic dirofilariasis" 4 => "Subcutaneous dirofilariasis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec874020" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Dirofilaria</span>" 1 => "<span class="elsevierStyleItalic">Dirofilaria repens</span>" 2 => "Dirofilariasis humana" 3 => "Dirofilariasis ocular" 4 => "Dirofilariasis subcutánea" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The case concerns a 33-year-old Ukrainian woman, who came to the Ophthalmology Emergency Service, stating that she had a “worm” under the skin of her upper left eyelid that wriggled at night and bit her. A complete examination revealed a subcutaneous foreign body, which showed a filarial appearance and seemed to crawl under the skin. It was surgically removed to discover a live parasite, PCR-identified as <span class="elsevierStyleItalic">Dirofilaria repens</span>.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Humans are accidental hosts in the cycle of Dirofilaria. There are only 8 reported cases of subcutaneous infection in Spain. Due to global warming, <span class="elsevierStyleItalic">D. repens</span> has become an emerging infectious agent in Central Europe countries such as Ukraine. The findings in this case are discussed.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mujer de 33 años, ucraniana, acude a urgencias asegurando tener alojado en el párpado un gusano que se mueve y le muerde. La exploración reveló un cuerpo extraño subcutáneo, filiforme, que reptaba bajo la piel. Fue extirpado quirúrgicamente extrayéndose un parásito vivo identificado por PCR como <span class="elsevierStyleItalic">Dirofilaria repens</span>.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los humanos son huéspedes accidentales en el ciclo de las dirofilarias. En España apenas se han publicado 8 casos de afectación subcutánea. Ante el calentamiento global <span class="elsevierStyleItalic">D. repens</span> se ha convertido en un agente infeccioso emergente en países de Centroeuropa como el originario de la paciente. Exponemos nuestras conclusiones.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rodríguez-Calzadilla M, Ruíz-Benítez MW, de-Francisco-Ramírez JL, Redondo-Campos AR, Fernández-Repeto-Nuche E, Gárate T, et al. Dirofilariasis palpebral causada por <span class="elsevierStyleItalic">Dirofilaria repens:</span> un caso importado. Arch Soc Esp Oftalmol. 2017;92:439–441.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0050" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 810 "Ancho" => 950 "Tamanyo" => 71357 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Eyeled at diagnostic.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 732 "Ancho" => 950 "Tamanyo" => 136339 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Surgically removed parasite.</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 156249 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human and animal dirofilariasis: the emergence of a zoonotic mosaic" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. 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