Mycetoma caused by Trichosporon asteroids-report of the first case

Mycetoma is a neglected disease that affects mainly the skin, but can progress to deep tissues and structures such as muscles and bones. Mycetoma can be caused by some bacterial (actinomycetoma) or fungal species (eumycetoma); furthermore, eumycetoma is estimated to account for 40% of all cases of mycetomas. Regardless of etiology, human infections occur after accidental implantation of etiological agents through the skin. In the present work, an immunocompetent patient without systemic comorbidity is reported to have exhibited a progressive increase of the left foot with multiple fistulas in the dorsum in the last 15 years, which emerged as a purulent secretion in the presence of yellowish grains. The patient reported that during a trip she suffered injuries in the affected foot. Histopathological study showed the presence of fungal grains, and the culture of skin fragments allowed the identification of fungal colonies exhibiting a dry, cream-coloured cerebriform morphology with a radiated peripheral edge. The micromorphology examination of the isolate demonstrated the presence of hyphae that swell and become multiseptate, budding cells, and lateral conidia were absent. MALD-TOF MS analysis led to the identification of Trichosporon asteroides as etiologic. Different treatment regimens were performed with no success, moderate improvement was observed with voriconazole, and treatment is still ongoing. This is the first case report to incriminate T. asteroides as an etiological agent of eumycetoma

Comparison of the Laryngeal View during Tracheal Intubation Using Airtraq and Macintosh Laryngoscopes by Unskillful Anesthesiology Residents: A Clinical Study

Background and Objective. The Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) is a novel tracheal intubation device. Studies, performed until now, have compared the Airtraq with the Macintosh laryngoscope, concluding that it reduces the intubation times and increase the success rate at first intubation attempt, decreasing the Cormack-Lehane score. The aim of the study was to evaluate if, in unskillful anesthesiology residents during the laryngoscopy, the Airtraq compared with the Macintosh laryngoscope improves the laryngeal view, decreasing the Cormack-Lehane score. Methods. A prospective, randomized, crossed-over trial was carried out on 60 patients. Each one of the patients were intubated using both devices by unskillful (less than two hundred intubations with the Macintosh laryngoscope and 10 intubations using the Airtraq) anesthesiology residents. The Cormack-Lehane score, the success rate at first intubation attempt, and the laryngoscopy and intubation times were compared. Results. The Airtraq significantly decreased the Cormack-Lehane score (P = 0.04). On the other hand, there were no differences in times of laryngoscopy (P = 0.645; IC 95% 3.1, +4.8) and intubation (P = 0.62; C95%  −6.1, +10.0) between the two devices. No relevant complications were found during the maneuvers of intubation using both devices. Conclusions. The Airtraq is a useful laryngoscope in unskillful anesthesiology residents improving the laryngeal view and, therefore, facilitating the tracheal intubation

On the analysis of the fractal basins of escape in the N‐body ring problem

This article summarizes the results of a numerical investigation of the phenomenon of escape in the N‐body ring configuration, focusing on the scenarios that result for N = 5, 6, 7, 8 peripheral bodies. There is a critical value of the Jacobi constant of the system such that for smaller values, the potential well opens and test particles may leave the potential through any of its N openings. By means of a surface of section, we show the results of the computation of the basins of escape towards the different directions of escape, analyzing the structures that appear in them

Mosaico Vítreo Retrorreflectante

Salquisa and Alttoglass have developed a very innovative product : the retro reflective glass mosaic. This new product can be used in both horizontal and vertical signposting and also in interior design and architecture. This particular product has many advantages compare to the traditional methods used for signposting, design or architecture. One of them is that the product is mainly made of glass therefore it can last much longer than paints for example. The used of glass mosaic for civil engineering it is opened up especially for signposting and it contributes to improve visibility at night not only in standard conditions but also in the hard ones such as wind, fog or rain at nighttimes. Higher visibility = higher security. We should remember that a high percentage of accidents occur under rain conditions at night. The glass mosaic is presented in a mesh which allows the use in both plane and curve surfaces in signposting, interior design and architecture. The retro reflective effect last under the water therefore the mosaic can be fixed in ornamental and decorative fountains, swimming pools, etc. Furthermore, the retro reflective effect can also be applied on big size ceramic tiles. This project was developed along with the Institute of Ceramic Technology (ITC), it was supported by the Center for Industrial Technological Development (CDTI) and it is also patente

Analysis of the escape in systems with four exit channels

In this paper, we have performed a numerical investigation of the escape of a particle from two different dynamical systems with the same number of exit channels. We have chosen specific values of the parameters of the systems so that the openings of the potential well in both systems are approximately of the same size. We have found that, in the galactic system, the distribution of the times of escape follows a sequential pattern that has never been detected before. Moreover, we have proved that this pattern is directly related to the geometry of the stable manifolds to the Lyapunov orbits located at the openings of the potential. Finally, we have shown that the different nature of the two systems affects the way the escape occurs, due to the difference in the geometry of the manifolds to the Lyapunov orbits in both systems

Chromoblastomycosis with 18 years of evolution

Chronic infectious, granulomatous and suppurative dermatosis, classified among the subcutaneous mycoses, caused by species of pigmented dematiaceous fungi, more prevalent in tropical and subtropical regions and caused by the traumatic implantation of dematiaceous fungal species, where the presence of muriform bodies are an expression of the causal agent in the grafted tissue, characteristic of chromoblastomycosis considered the second implantation mycosis in the world, it manifests itself with slow and progressive growth lesions of exophytic and verrucous plaques and black dots on the surface. The disease is considered a neglected and occupational disease, which occurs mainly among agricultural workers, and coconut and babassu harvesters, lumberjacks and traders of agricultural products. It is important to highlight that people at risk of contracting chromoblastomycosis work in tropical countries, where the temperature can be above 40 °C in summer, and generally refuse to wear protective equipment during the day (shoes, gloves, and clothes), although they know that this type of prophylactic measure can prevent different types of diseases. These vulnerable people often live in low-income countries and sometimes live far from medical services and, once infected, do not seek medical attention. We report below an exuberant and unusual case of lower limb chromoblastomycosis with a history of 18 years of evolution. The diagnosis was established by direct mycological examination, culture and microculture that identified the agent of the Fonsecaea species, and histopathological examination.

Assessing the Left Ventricular Systolic Function at the Bedside: The Role of Transpulmonary Thermodilution-Derived Indices

Evaluating the systolic function of the left ventricle (LV) is important in the hemodynamic management of the critically ill patients with circulatory failure. Echocardiography is considered the standard monitor for estimating the LV function at the bedside in the intensive care unit. However, it requires a trained operator and is not a real-time monitoring tool. For monitoring of the systolic function, the pulmonary artery catheter has been the gold standard for a long time. However, now there are alternatives to this device, with transpulmonary thermodilution being one of them. This paper provides an overview of the usefulness of the transpulmonary thermodilution-derived indices for assessing systolic function at the bedside

Genetic differentiation between insular and continental populations of migratory and resident warblers, the Great Reed Warbler Acrocephalus arundinaceus and the Cetti's Warbler Cettia cetti Journal of Ornithology

[EN] Island populations are frequently smaller than continental populations, have lower genetic diversity, are more inbred and show genetic differentiation from the mainland ones. However, sufficient numbers of immigrants may reduce the differentiation of insular populations and moderate the effects of genetic drift. In this study, we compared insular and continental populations of Cetti¿s Warbler Cettia cetti and Great Reed Warbler Acrocephalus arundinaceus. We assessed the degree of genetic differentiation between insular and continental birds, their demographic history and genetic diversity. We compared the results, taking into account the differences in migration strategy and morphology of the two warblers. We found slightly lower genetic diversity in the insular populations than in the continental birds, possibly because of the lower population size or reduced immigration. The genetic differentiation between island and mainland birds was low, but higher in Cetti¿s Warbler than in the Great Reed Warbler, suggesting differences in the species¿ capability of crossing the sea. We found evidence for a past bottleneck in both the insular and continental populations of Cetti¿s Warbler, while for the Great Reed Warbler we found no signs of past population reductions. A high dispersal capability of the Great Reed Warbler may have allowed high gene flow, which may explain the observed interspecific differences in the demographic history of the Great Reed Warbler and Cetti¿s Warbler.We acknowledge M. Rebassa, H. Rguibi-Idrissi, M. Marin, J. Gomez, Santi, Luis, Kames and family and many others, who have helped us with the fieldwork. We would also like to thank the authorities of the Marjal de Pego-Oliva Natural Park, the S'Albufera de Mallorca Natural Park, the Consejeria de medio Ambiente y Desarrollo Rural de Castilla-La Mancha, the Servei de Conservacio de la Biodiversitat de la Generalitat Valenciana and the Haut Commissariat aux Eaux et Forets et a la lutte contre la desertification de Rabat, Morocco for providing the facilities to work in protected areas and for the relevant permits. We are grateful to M. Serra and the researchers and Ph.D. students of the Laboratory of Evolutionary Ecology (Institute Cavanilles of Biodiversity and Evolutionary Biology University of Valencia), for providing a laboratory for DNA extraction. This study has been partly financed by projects CGL2005-02041/BOS and CGL201021933-0O2-02 of the Spanish Ministry of Science and Innovation and by the University of Oulu. F. Ceresa was supported by an Atraent talent grant from the University of Valencia.Ceresa, F.; Belda, E.; Kvist, L.; Kajanus, M.; Monrós González, JS. (2018). Genetic differentiation between insular and continental populations of migratory and resident warblers, the Great Reed Warbler Acrocephalus arundinaceus and the Cetti's Warbler Cettia cetti Journal of Ornithology. Journal of Ornithology (Online). 159(3):703-712. https://doi.org/10.1007/s10336-018-1543-2S703712159