Use of Preputial Skin as Cutaneous Graft after Nevus Excision

We report a four-year-old boy with a nevus covering all the plantar side of his second finger on the left foot. He was also affected by congenital phimosis. Surgical excision of the nevus was indicated, but the skin defect would have been too large to be directly closed. The foreskin was taken as a full-thickness skin graft to cover the cutaneous defect of the finger. The graft intake was favourable and provided a functional repair with good aesthetic characteristic

Missense mutations in the Fas gene resulting in autoimmune lymphoproliferative syndrome: a molecular and immunological analysis

Programmed cell death (or apoptosis) is a physiological process essential to the normal development and homeostatic maintenance of the immune system. The Fas/Apo-1 receptor plays a crucial role in the regulation of apoptosis, as demonstrated by lymphoproliferation in MRL-lpr/lpr mice and by the recently described autoimmune lymphoproliferative syndrome (ALPS) in humans, both of which are due to mutations in the Fas gene. We describe a novel family with ALPS in which three affected siblings carry two distinct missense mutations on both the Fas gene alleles and show lack of Fas-induced apoptosis. The children share common clinical features including splenomegaly and lymphadenopathy, but only one developed severe autoimmune manifestations. In all three siblings, we demonstrated the presence of anergic CD3+CD4-CD8- (double negative, [DN]) T cells; moreover, a chronic lymphocyte activation was found, as demonstrated by the presence of high levels of HLA-DR expression on peripheral CD3+ cells and by the presence of high levels of serum activation markers such as soluble interleukin-2 receptor (slL-2R) and soluble CD30 (sCD30)

Mediciones anuales comparadas de viento y energía producida en un sistema eólico aislado para escuela rural

El presente trabajo exhibe la comparación de series anuales de datos de viento con estación automática, la predicción energética asociada, y la energía realmente producida por el sistema eólico de 4kw nominales ( 5 turbinas de 800w) instalado en una escuela rural aislada en la provincia de santa cruz. estas mediciones se realizaron durante 2001 utilizando una estación de viento NRG EXPLORER y un equipo SISMED-01/48 de adquisición de datos. los cálculos de energía de viento disponible fueron realizados utilizando software comercial NRG y planillas específicas para los parámetros de Weibull y estimación de energía, basadas en un tiempo de muestreo de 10 minutos. los cálculos de energía eléctrica son almacenados en forma de promedios diarios para cada aerogenerador. los datos permiten obtener varias conclusiones de interés, entre ellas la influencia de la pérdida de rendimiento ocasionada por la desadaptación de impedancias entre el aerogenerador de iman permanente y el banco de baterías.This paper presents results derived from compared measurements of wind intensity, direction and power in an isolated battery-charging system for a rural school in patagonia. the 2001 databases from an nrg logger and a sismed-01 specialized data acquisition system are processed using nrg software and conventional spreadsheets, allowing for a number of performance issues to be described.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Mediciones anuales comparadas de viento y energía producida en un sistema eólico aislado para escuela rural

El presente trabajo exhibe la comparación de series anuales de datos de viento con estación automática, la predicción energética asociada, y la energía realmente producida por el sistema eólico de 4kw nominales ( 5 turbinas de 800w) instalado en una escuela rural aislada en la provincia de santa cruz. estas mediciones se realizaron durante 2001 utilizando una estación de viento NRG EXPLORER y un equipo SISMED-01/48 de adquisición de datos. los cálculos de energía de viento disponible fueron realizados utilizando software comercial NRG y planillas específicas para los parámetros de Weibull y estimación de energía, basadas en un tiempo de muestreo de 10 minutos. los cálculos de energía eléctrica son almacenados en forma de promedios diarios para cada aerogenerador. los datos permiten obtener varias conclusiones de interés, entre ellas la influencia de la pérdida de rendimiento ocasionada por la desadaptación de impedancias entre el aerogenerador de iman permanente y el banco de baterías.This paper presents results derived from compared measurements of wind intensity, direction and power in an isolated battery-charging system for a rural school in patagonia. the 2001 databases from an nrg logger and a sismed-01 specialized data acquisition system are processed using nrg software and conventional spreadsheets, allowing for a number of performance issues to be described.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Mediciones anuales comparadas de viento y energía producida en un sistema eólico aislado para escuela rural

El presente trabajo exhibe la comparación de series anuales de datos de viento con estación automática, la predicción energética asociada, y la energía realmente producida por el sistema eólico de 4kw nominales ( 5 turbinas de 800w) instalado en una escuela rural aislada en la provincia de santa cruz. estas mediciones se realizaron durante 2001 utilizando una estación de viento NRG EXPLORER y un equipo SISMED-01/48 de adquisición de datos. los cálculos de energía de viento disponible fueron realizados utilizando software comercial NRG y planillas específicas para los parámetros de Weibull y estimación de energía, basadas en un tiempo de muestreo de 10 minutos. los cálculos de energía eléctrica son almacenados en forma de promedios diarios para cada aerogenerador. los datos permiten obtener varias conclusiones de interés, entre ellas la influencia de la pérdida de rendimiento ocasionada por la desadaptación de impedancias entre el aerogenerador de iman permanente y el banco de baterías.This paper presents results derived from compared measurements of wind intensity, direction and power in an isolated battery-charging system for a rural school in patagonia. the 2001 databases from an nrg logger and a sismed-01 specialized data acquisition system are processed using nrg software and conventional spreadsheets, allowing for a number of performance issues to be described.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Envelhecimento (in)ativo e desenvolvimento emocional em reclusos

Este projeto pretende apresentar o contributo do programa de Exercício Físico e do Desenvolvimento Emocional nos reclusos. Para isso optamos por desenvolver um estudo de carácter Quantitativo, Exploratório, Quasi - Experimental, Longitudinal e Descritivo. A amostra é constituída por 20 reclusos do Estabelecimento Prisional de Izeda, com idade média de 41,10±10,19 anos, distribuída entre os 24 e os 67 anos. Dos 20 reclusos, 9 foram designados para integrarem o Grupo de Investigação e os restantes o Grupo de Controlo. A seleção foi feita de forma aleatória. O Grupo de Investigação foi submetido a um programa de atividades de duas a três sessões semanais, durante 8 semanas, tendo cada sessão a duração de 1:15 Horas. Foi aplicada a escala EVCE e o questionário SF-36v2, com a complementaridade das avaliações do estado funcional dos reclusos. As características psicométrica obtidas na escala EVCE e no questionário SF-36v2 permitem-nos verificar que neste estudo se obtem uma boa consistência interna. Após a realização das sessões de intervenção, verificamos que não houve alterações estatisticamente significativas entre os parâmetros do Grupo de Controlo e o Grupo de Investigação. Desta forma, podemos concluir que o programa de intervenção teria melhores resultados se tivesse uma duração maior ao longo do tempo.This project aims to present the contribution of an Exercise Program and of an Emotional Development Program in prison. For this study we chose to develop a Quantitative Explorational, Quasi - Experimental, Descriptive and Longitudinal. The sample consists of 20 inmates of the Izeda Prison, with a mean age of 41.10± 10.19 years, distributed between 24 and 67 years. Of the 20 inmates, nine were appointed to serve on the Research Group and the remaining To the Control Group. The selection was done randomly. The Research Group has undergone program of activities two to three times per week for 8 weeks, with each session lasting 1h15m. EVCE scale and SF-36v2 were applied, the functional status of the inmates was assessed. The psychometric characteristics obtained in EVCE scale and SF-36v2 allow us to verify that this study gives a good internal consistency. After completion of intervention sessions, we found that there were no statistically significant changes between the parameters of the Control Group and Research Group. Thus, we can conclude that the intervention program would have better results if it had a longer duration over tim

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

The primary headaches: genetics, epigenetics and a behavioural genetic model

The primary headaches, migraine with (MA) and without aura (MO) and cluster headache, all carry a substantial genetic liability. Familial hemiplegic migraine (FHM), an autosomal dominant mendelian disorder classified as a subtype of MA, is due to mutations in genes encoding neural channel subunits. MA/MO are considered multifactorial genetic disorders, and FHM has been proposed as a model for migraine aetiology. However, a review of the genetic studies suggests that the FHM genes are not involved in the typical migraines and that FHM should be considered as a syndromic migraine rather than a subtype of MA. Adopting the concept of syndromic migraine could be useful in understanding migraine pathogenesis. We hypothesise that epigenetic mechanisms play an important role in headache pathogenesis. A behavioural model is proposed, whereby the primary headaches are construed as behaviours, not symptoms, evolutionarily conserved for their adaptive value and engendered out of a genetic repertoire by a network of pattern generators present in the brain and signalling homeostatic imbalance. This behavioural model could be incorporated into migraine genetic research