HOME-MADE FROZEN STENTED ELEPHANT TRUNK FOR ACUTE ARCH DISSECTION: AN HYBRID OFF-THE-SHELF TREATMENT IN AN EMERGENCY SETTING

Introduction: Involvement of the ascending/aortic arch in the thoracic aorta pathology can preclude thoracic endovas- cular aortic repair (TEVAR) due to the absence of an adequate proximal landing zone. Hybrid interventions combining ascending/aortic arch replacement with TEVAR of the descending thoracic aorta (DTA) are associated with good outcomes. Despite the existence of dedicated devices (E-vita®, Thoraflex®), they may not be available in good time in emergent cases that might require inventive solutions, like the one we present. Case Report: A 53-year-old hypertensive, active smoker male was admitted due to a non-A-non-B acute aortic dissection, complicated with a contained rupture at the aortic isthmus and a left haemothorax. Considering the absence of a secure proximal landing zone we decided on an aortic arch replacement and frozen stented elephant trunk using off-the-shelf devices. Debranching of the innominate and left common carotid arteries was performed with a 16×8mm bifurcated graft. The aortic arch replacement was performed with a 28 mm Dacron, under hypothermic circulatory arrest. A 30×30×157mm stent graft was anterogradely advanced to the DTA, under direct vision, with its proximal part parked at the level of the Dacron anastomosis. The proximal arch anastomosis was completed at the level of the sinotubular junction. Completion angiography revealed appropriately reconstructed aortic arch, successful exclusion of the entry tear and rupture site, as well as adequate renal and visceral perfusion. The patient had an uneventful postoperative course, being discharged on postoperative day 23. Control CTA demonstrated successful arch reconstruction, true lumen expansion and no signs of complications. Conclusion: This hybrid approach with off-the-shelf devices was successful and avoided the cumulative morbidity of an additional left thoracotomy as the technical difficulty of a full open surgery in this setting. In the absence of readily available dedicated devices, hybrid techniques will undoubtedly play a role in the treatment of acute aortic syndromes. The existence of an “Aortic Team” available to evaluate, decide and combine the expertise of cardiothoracic and vascular surgery was essential in this case

Genome of Rhodnius prolixus, an insect vector of Chagas disease, reveals unique adaptations to hematophagy and parasite infection

Rhodnius prolixus not only has served as a model organism for the study of insect physiology, but also is a major vector of Chagas disease, an illness that affects approximately seven million people worldwide. We sequenced the genome of R. prolixus, generated assembled sequences covering 95% of the genome ( approximately 702 Mb), including 15,456 putative protein-coding genes, and completed comprehensive genomic analyses of this obligate blood-feeding insect. Although immune-deficiency (IMD)-mediated immune responses were observed, R. prolixus putatively lacks key components of the IMD pathway, suggesting a reorganization of the canonical immune signaling network. Although both Toll and IMD effectors controlled intestinal microbiota, neither affected Trypanosoma cruzi, the causal agent of Chagas disease, implying the existence of evasion or tolerance mechanisms. R. prolixus has experienced an extensive loss of selenoprotein genes, with its repertoire reduced to only two proteins, one of which is a selenocysteine-based glutathione peroxidase, the first found in insects. The genome contained actively transcribed, horizontally transferred genes from Wolbachia sp., which showed evidence of codon use evolution toward the insect use pattern. Comparative protein analyses revealed many lineage-specific expansions and putative gene absences in R. prolixus, including tandem expansions of genes related to chemoreception, feeding, and digestion that possibly contributed to the evolution of a blood-feeding lifestyle. The genome assembly and these associated analyses provide critical information on the physiology and evolution of this important vector species and should be instrumental for the development of innovative disease control methods

El hogar que envejece

La casa aislada fue una tipología esencial de la producción arquitectónica del siglo XX, y se ha convertido en un fértil campo de investigación para los arquitectos modernos, que compartían el entendimiento de que debían proyectar todo: el edificio, su entorno, los interiores y todo lo que estuviera ahí adentro. Pero, así como es esencial esto reconocimiento, de que el diseño de interiores forma parte del proyecto moderno, es igualmente necesario considerar que estos son, esencialmente, sistemas abiertos, más susceptibles al cambio. El paso del tiempo o el simple deseo de interferir en el hogar pueden alterar diseños originales. Este texto se detiene en un grupo de cuatro casas modernas –Villa Savoye, Casa Tugendhat, Tacubaya y la Casa de Vidro– y, a través de esta observación, intenta comprender cómo estos interiores han envejecido; cómo han cambiado o no, por la acción de quién y de qué manera.The isolated house was an essential typology in the architectural production of the 20th century and has become a fertile field of research for modern architects, who share the understanding that they must to project everything: the building itself, its surroundings, its interiors and everything inside. But, just as this recognition is essential, that interior design is part of the modern project, it is equally necessary to consider that they are essentially open systems, more susceptible to change. The passage of time or the simple desire to interfere in the home can alter original designs. This work will examine a group of four modern houses –Villa Savoye, Tugendhat House, Tacubaya and Casa de Vidro– and, through this observation, will try to understand how these interiors have aged; how they have changed or not, by whos action and in what way

A sala bem temperada interior moderno e sensibilidade eclética

A ambientação de interiores é uma dimensão fundamental da arquitetura moderna que está interessada no desaparecimento da fronteira entre interior e exterior, na continuidade espacial, na transparência, na redução das paredes e na flexibilidade dos espaços; tudo isto sob a regência de um espírito único e harmonioso, comandado pelo arquiteto. Este trabalho, então, analisa as ambientações projetadas para os salões de algumas das casas consagradas produzidas entre 1930 e 1950, especialmente, e procura estabelecer as possíveis relações desta produção, entre contemporâneos e deles com seus antecedentes históricos. O ponto de partida é a constatação inicial de que há diferentes maneiras de tratar o assunto. A inserção desta variável, ambientação de interiores, amplia o espectro de análise da arquitetura moderna, possibilitando uma visão mais abrangente e completa de sua produção, além de buscar e organizar o material relativo ao assunto. A opção pelo tema residencial é consequência da importância que ele asssume no período, estabelecendo-se como programa preponderante e valioso campo de experimentação de idéias. As casas são aquelas de uma elite, não apenas econômica, mas também cultural, disposta a patrocinar e identificar-se com a vanguarda arquitetônica, e o foco da análise recai nos ambientes socias e de representação.The interior design is a fundamental dimension of modern architecture that is interested in the disappearing of the barriers between the interior and exterior, in the space continuity, in the transparency, in the reduction of the walls and in the flexibility of the spaces; all that under the regency of a unique and harmonious spirit, led by the architect. This work, then, analyses the designs created for the rooms of some of the well-known houses produced specially between 1930 and 1950, and intends to establish the possible relations of this production among the contemporaries and from them with their historical antecedents. The starting point is the initial understanding that there are different ways of dealing with the presented subject. The insertion of this variable, the interior design, extends the spectrum of the analysis of modern architecture, enabling a more including and complete vision of its production, and also searches and organizes the material related to the subject. The option for the residential theme is a consequence of the importance it takes in the period, establishing itself as a preponderant program and valuable field of experimenting of ideas. The houses are those from the elite, not only economical, but also cultural, willing to sponsor and identify to the architectural avant guard, and the focus of the analysis falls on the social and representative rooms

European Architectural History Network, EAHN 2022 : 7th International Meeting. Conference Proceedings

The 7th EAHN Biennial Meeting (Madrid, June 15-19, 2022) attracted a relevant collection of papers on various topics. Like its predecessors, EAHN 2022 aimed to promote high quality research. As a diverse field, architectural history requires interaction and discussion among people with different interests and backgrounds. Beginning and experienced theorists and practitioners, people from different disciplines and different countries gathered both in person and virtually to learn from and contribute to each other’s growth. The conference was organized in two calls. The first one to define the sessions and round tables, and the second one to select the participants. In the first call there were a total of 85 session and roundtable proposals, evaluated in 5 peer-reviewed tracks. Of these, the following contributions were accepted: 20 sessions and 5 roundtables . To participate in these, a total of 486 submissions, evaluated in 25 peer-reviewed tracks, were received. The acceptance rate for contributions received in the peer-reviewed tracks was 29,41% for session and roundtable proposals, 25,72% for full papers and roundtable lectures, and 41,51% for interest group meeting participants. Many of these contributions were accepted after further review to be included in the present proceedings. The final decision on acceptance or rejection of full papers was taken in an Editorial Committee meeting held in September 2022. The meeting discussed a consistent set of criteria to deal with inevitable differences among many reviewers, and the expert advice of the corresponding session chairs and reviewers was taken in consideration