Relation between the area affected by Fournier's gangrene and the type of reconstructive surgery used: a study with 80 patients

OBJECTIVE: To assess the affected skin area and the reconstructive techniques used in 80 patients affected by Fournier's gangrene. MATERIALS AND METHODS: Eighty patients ranging in age from 19 to 85 years (mean = 51) affected by Fournier's gangrene were studied. When admitted to the emergency room the patients were submitted to clinical and laboratory examinations to analyze the gravity of the case. All patients were submitted to an extensive debridement of the lesion, urinary derivation by cystostomy and colostomy whenever necessary. RESULTS: Only 13 patients (16.25%) died. From the 67 remaining patients, in 44 (65.6%) debridement was restricted to the scrotum, in 10 (14.9%) there has been scrotum and penile lesions and in 13 (19.3%) there has been a debridement of the scrotum and the perineal region. In 11 cases (16.4%) there was no need for reconstructive surgery with wound closing by second intention, in 16 cases (23.8%) reconstructive surgery was performed with mobilization of local skin, in 19 (28.3%) we have used skin grafts, 20 patients (29.8%) needed reconstructive surgery with the use of skin flaps and in 1 case (1.4%) there has been the use of skin flaps and grafts simultaneously. CONCLUSIONS: Fournier's gangrene is a serious pathology and should be treated aggressively with an extensive debridement of the area with necrosis. The use of precocious reconstructive surgery of the genitals present good results and tends to greatly reduce the length of hospital stay and improve the psychological conditions of these patients

Attitudes towards the focus and style of political representation among Belgian, French and Portuguese Parliamentarians

This article analyzes the attitudes of members of parliament towards representation. Based on the PARENEL project dataset, it takes an individual-level approach to examine the focus and style of representation of Belgian, French and Portuguese representatives. It shows that, given the complexity of the process of representation, MPs have various principals and develop multiple foci of representation. It also demonstrates the impact of electoral rules, career patterns and MP’s goals on their focus of representation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

G1/S Transcription Factor Orthologues Swi4p and Swi6p Are Important but Not Essential for Cell Proliferation and Influence Hyphal Development in the Fungal Pathogen Candida albicans▿†

The G1/S transition is a critical control point for cell proliferation and involves essential transcription complexes termed SBF and MBF in Saccharomyces cerevisiae or MBF in Schizosaccharomyces pombe. In the fungal pathogen Candida albicans, G1/S regulation is not clear. To gain more insight into the G1/S circuitry, we characterized Swi6p, Swi4p and Mbp1p, the closest orthologues of SBF (Swi6p and Swi4p) and MBF (Swi6p and Mbp1p) components in S. cerevisiae. The mbp1Δ/Δ cells showed minor growth defects, whereas swi4Δ/Δ and swi6Δ/Δ yeast cells dramatically increased in size, suggesting a G1 phase delay. Gene set enrichment analysis (GSEA) of transcription profiles revealed that genes associated with G1/S phase were significantly enriched in cells lacking Swi4p and Swi6p. These expression patterns suggested that Swi4p and Swi6p have repressing as well as activating activity. Intriguingly, swi4Δ/Δ swi6Δ/Δ and swi4Δ/Δ mbp1Δ/Δ strains were viable, in contrast to the situation in S. cerevisiae, and showed pleiotropic phenotypes that included multibudded yeast, pseudohyphae, and intriguingly, true hyphae. Consistently, GSEA identified strong enrichment of genes that are normally modulated during C. albicans-host cell interactions. Since Swi4p and Swi6p influence G1 phase progression and SBF binding sites are lacking in the C. albicans genome, these factors may contribute to MBF activity. Overall, the data suggest that the putative G1/S regulatory machinery of C. albicans contains novel features and underscore the existence of a relationship between G1 phase and morphogenetic switching, including hyphal development, in the pathogen