What did Hughes teach us about repairing surgical defects in the lower eyelid?

La reconstrucción del párpado inferior sigue siendo un reto, especialmente la reparación de defectos que abarcan más de la mitad de su superficie horizontal. El colgajo de Hughes del párpado superior ipsilateral es la técnica quirúrgica de elección para los tumores de gran tamaño del párpado inferior. Presentamos el caso de una paciente con carcinoma basocelular superficial de párpado inferior izquierdo que fue intervenida con extirpación del tumor con margen de seguridad y reparación del defecto primario mediante este colgajo. Describimos la técnica de Hughes paso a paso, sus potenciales complicaciones, así como los puntos clave en su ejecución para conseguir unos resultados satisfactorios.Lower eyelid reconstrution remains a challenge, especially the repair of defects that cover more than a half of its horizontal surface. The Hughes flap of the ipsilateral upper eyelid is the surgical technique of choice for large tumors of the lower eyelid. We present the case of a patient with superficial basal cell carcinoma of the lower left eyelid who underwent surgery with excision of the tumor with margin of safety and repair of the primary defect using this flap. We describe the Hughes technique step by step, its potential complications, as well as the key points in its execution to achieve satisfactory results

Operators on the Fréchet sequence space ces(p+), 1≤p<∞1 \leq p < \infty

[EN] The Fréchet sequence spaces ces(p+) are very different to the Fréchet sequence spaces ¿p+,1¿pp}\ell ^q$$ ℓ p + = ∩ q > p ℓ q . Math. Nachr. 147, 7–12 (1990)Pérez Carreras, P., Bonet, J.: Barrelled Locally Convex Spaces. North Holland, Amsterdam (1987)Pitt, H.R.: A note on bilinear forms. J. Lond. Math. Soc. 11, 171–174 (1936)Ricker, W.J.: A spectral mapping theorem for scalar-type spectral operators in locally convex spaces. Integral Equ. Oper. Theory 8, 276–288 (1985)Robertson, A.P., Robertson, W.: Topological Vector Spaces. Cambridge University Press, Cambridge (1973)Waelbroeck, L.: Topological vector spaces and algebras. Lecture Notes in Mathematics, vol. 230. Springer, Berlin (1971

Elastic Image Registration of 2-D Gels for Differential and Repeatability Studies

One of the main applications of electrophoretic 2-D gels is the analysis of differential responses between different conditions. For this reason, specific spots are present in one of the images, but not in the other. In some other occasions, the same experiment is repeated between 2 and 12 times in order to increase statistical significance. In both situations, one of the major difficulties of these analysis is that 2-D gels are affected by spatial distortions due to run-time differences and dye-front deformations, resulting in images that are significantly dissimilar not only because of their content, but also because of their geometry. In this technical brief, we show how to use free, state-of-the-art image registration and fusion algorithms developed by us for solving the problem of comparing differential expression profiles, or computing an "average" image from a series of virtually identical gels

Basal oxidation of conserved cysteines modulates cardiac titin stiffness and dynamics

Titin, as the main protein responsible for the passive stiffness of the sarcomere, plays a key role in diastolic function and is a determinant factor in the etiology of heart disease. Titin stiffness depends on unfolding and folding transitions of immunoglobulin-like (Ig) domains of the I-band, and recent studies have shown that oxidative modifications of cryptic cysteines belonging to these Ig domains modulate their mechanical properties in vitro. However, the relevance of this mode of titin mechanical modulation in vivo remains largely unknown. Here, we describe the high evolutionary conservation of titin mechanical cysteines and show that they are remarkably oxidized in murine cardiac tissue. Mass spectrometry analyses indicate a similar landscape of basal oxidation in murine and human myocardium. Monte Carlo simulations illustrate how disulfides and S-thiolations on these cysteines increase the dynamics of the protein at physiological forces, while enabling load- and isoform-dependent regulation of titin stiffness. Our results demonstrate the role of conserved cysteines in the modulation of titin mechanical properties in vivo and point to potential redox-based pathomechanisms in heart disease.This work was supported by the Ministerio de Ciencia e Innovación grants BIO2014-54768-P, BIO2017-83640-P, RYC-2014-16604 to JAC and PGC2018-097019-B-I00 to JV, the Regional Government of Madrid grants S2018/NMT-4443 and PEJ16/MED/TL-1593 to JAC and the Instituto de Salud Carlos III (Fondo de Investigación Sanitaria grant PRB3 (PT17/0019/0003- ISCIII-SGEFI /ERDF, ProteoRed), and “la Caixa” Banking Foundation (project code HR17-00247) to JV. We acknowledge funding from the European Research Area Network on Cardiovascular Disease through grant MINOTAUR to SS (The Austrian Science Fund – FWF, I3301) and JAC (ISCIII-AC16/00045). The CNIC is supported by ISCIII, the Ministerio de Ciencia e Innovación and the Pro CNIC Foundation, and was a Severo Ochoa Center of Excellence (SEV-2015-0505). IMM was the recipient of a CNIC-ACCIONA Masters Fellowship and holds a fellowship from “La Caixa” Foundation (ID 100010434, fellowship code LCF/BQ/DR20/11790009). CSC is the recipient of an FPI-SO predoctoral fellowship BES-2016-076638. We thank Wolfgang A. Linke and Pablo García-Pavía for critical feedback. We are also thankful for the insights of three anonymous reviewers.S

Multicenter prospective clinical study to evaluate children short-term neurodevelopmental outcome in congenital heart disease (children NEURO-HEART): study protocol.

BACKGROUND: Congenital heart disease (CHD) is the most prevalent congenital malformation affecting 1 in 100 newborns. While advances in early diagnosis and postnatal management have increased survival in CHD children, worrying long-term outcomes, particularly neurodevelopmental disability, have emerged as a key prognostic factor in the counseling of these pregnancies. METHODS: Eligible participants are women presenting at 20 to < 37 weeks of gestation carrying a fetus with CHD. Maternal/neonatal recordings are performed at regular intervals, from the fetal period to 24 months of age, and include: placental and fetal hemodynamics, fetal brain magnetic resonance imaging (MRI), functional echocardiography, cerebral oxymetry, electroencephalography and serum neurological and cardiac biomarkers. Neurodevelopmental assessment is planned at 12 months of age using the ages and stages questionnaire (ASQ) and at 24 months of age with the Bayley-III test. Target recruitment is at least 150 cases classified in three groups according to three main severe CHD groups: transposition of great arteries (TGA), Tetralogy of Fallot (TOF) and Left Ventricular Outflow Tract Obstruction (LVOTO). DISCUSSION: The results of NEURO-HEART study will provide the most comprehensive knowledge until date of children's neurologic prognosis in CHD and will have the potential for developing future clinical decisive tools and improving preventive strategies in CHD

A global view on the riparian forests with Salix neotricha and Populus alba in the Iberian Peninsula (Portugal and Spain)

Forests dominated by Salix neotricha, and Populus alba found along the mesoeutrophic rivers in the Iberian Peninsula, were studied. We discuss the floristic circumscription, chorology, and community segregation based on the available releve´s of all Iberian riparian communities included in Populenion albae. Eleven formerly described communities were analyzed and due to original floristic combination, habitat features, and biogeographic scope, a new willow and poplar forest type is proposed within a well-defined biogeographical unit (Sadensean-Dividing Portuguese Subprovince): Clematido campaniflorae- Salicetum neotrichae. This syntaxon is found under a semi-hyperoceanic thermomediterranean to lower mesomediterranean, subhumid to humid bioclimate. Cluster analysis including all Iberian communities of Populenion albae shows a clear floristic segregation within the suballiance and confirms the originality of the new association. Furthermore, chemical characteristics of the water along some of the Portuguese watercourses with Populenion albae were studied and compared to the oligotrophic rivers occupied by Osmundo-Alnion communities. This study suggests that floristic separation between the communities of Populenion and Osmundo-Alnion is accompanied by a differentiation of the water trophic level

Insufficient antiretroviral therapy in pregnancy: missed opportunities for prevention of mother-to-child transmission of HIV in Europe

Background: Although mother-to-child transmission (MTCT) rates are at an all-time low in Western Europe, potentially preventable transmissions continue to occur. Duration of antenatal combination antiretroviral therapy (ART) is strongly associated with MTCT risk.Methods: Data on pregnant HIV-infected women enrolled in the Western and Central European sites of the European Collaborative Study between January 2000 and July 2009 were analysed. The proportion of women receiving no antenatal ART or 1-13 days of treatment was investigated, and associated factors explored using logistic regression models.Results: Of 2,148 women, 142 (7%) received no antenatal ART, decreasing from 8% in 2000-2003 to 5% in 2004-2009 (chi(2)=8.73; P= 14 days antenatal ART and 7.4% (10/136) among those with insufficient ART.Conclusions: Over the last 10 years, around one in 11 women in this study received insufficient antenatal ART, accounting for 40% of MTCTs. One-half of these women were diagnosed before conception, suggesting disengagement from care

Background rates of 41 adverse events of special interest for COVID-19 vaccines in 10 European healthcare databases - an ACCESS cohort study

BACKGROUND: In May 2020, the ACCESS (The vACCine covid-19 monitoring readinESS) project was launched to prepare real-world monitoring of COVID-19 vaccines. Within this project, this study aimed to generate background incidence rates of 41 adverse events of special interest (AESI) to contextualize potential safety signals detected following administration of COVID-19 vaccines. METHODS: A dynamic cohort study was conducted using a distributed data network of 10 healthcare databases from 7 European countries (Italy, Spain, Denmark, The Netherlands, Germany, France and United Kingdom) over the period 2017 to 2020. A common protocol (EUPAS37273), common data model, and common analytics programs were applied for syntactic, semantic and analytical harmonization. Incidence rates (IR) for each AESI and each database were calculated by age and sex by dividing the number of incident cases by the total person-time at risk. Age-standardized rates were pooled using random effect models according to the provenance of the events. FINDINGS: A total number of 63,456,074 individuals were included in the study, contributing to 211.7 million person-years. A clear age pattern was observed for most AESIs, rates also varied by provenance of disease diagnosis (primary care, specialist care). Thrombosis with thrombocytopenia rates were extremely low ranging from 0.06 to 4.53/100,000 person-years for cerebral venous sinus thrombosis (CVST) with thrombocytopenia (TP) and mixed venous and arterial thrombosis with TP, respectively. INTERPRETATION: Given the nature of the AESIs and the setting (general practitioners or hospital-based databases or both), background rates from databases that show the highest level of completeness (primary care and specialist care) should be preferred, others can be used for sensitivity. The study was designed to ensure representativeness to the European population and generalizability of the background incidence rates. FUNDING: The project has received support from the European Medicines Agency under the Framework service contract nr EMA/2018/28/PE