Projecte de reforma d’un habitatge unifamiliar entre mitgeres i adequació de les instal•lacions al Codi Tècnic de l’Edificació

Remodelació d’un habitatge unifamiliar de dos plantes entre mitgeres a Campdevànol amb l’adequació de les instal•lacions al Codi Tècnic de d’Edificació (CTE). L’estudi incideix especialment en l’estalvi energètic i la millora de l’eficiència energètica

Disseny i càlcul de les façanes i del lluernari del vestíbul d’entrada de la torra Iberdrola

El projecte Torre Iberdrola s’engloba en les actuacions urbanístiques de Bilbao per a regenerar espais industrials no utilitzats situats al Paseo de la Ribera, la Avenida Abandoibarra i la passarel•la Pedro Arrupe. La Torre Iberdrola, situada a la parcel•la 204 del PERI de Abandoibarra (veure plànol nº2), en el districte de Abando (Bilbao), és un gratacels d’oficines de 41 plantes amb una altura total de 165 metres i una superfície construïda total d’aproximadament 62.100 m2 sobre rasant. A més, l’edifici a construir consta de 5 plantes sota rasant amb una superfície total construïda d’aproximadament 32.100 m2. L’objecte del present projecte és presentar la solució acordada conjuntament entre l’arquitecte Pelli Clarke Pelli Architects, les consultories Buro Happold i IDOM, i BELLAPART per a l’execució del revestiment del vestíbul d’entrada de la Torre Iberdrola

Projecte bàsic i d'execució de rehabilitació i ampliació d'edifici plurifamiliar entre mitgeres situat al Carrer Roger de Flor, 105 de Granollers (Barcelona)

L’edifici a rehabilitar està situat en una important avinguda de l’eixample oest de Granollers. En l’actualitat l’edifici es troba a ple rendiment, amb l’ús de magatzem i obrador a la planta baixa i planta primera, i com a habitatge a les plantes segona i tercera. En concret es tracta de la formació d’un total de 6 habitatges i 5 trasters, a més de la reforma general del nucli de comunicació vertical on s’incorpora l’ascensor i la construcció de la paret mitgera que delimitarà l’espai de l’edifici en la seva projecció vertical. La rehabilitació també té com a objectiu reforçar els forjats, en els quals s’ha detectat aluminosi, així com l’enderroc d’envans a la segona i tercera planta per construir una millor distribució que permeti augmentar el nombre d’habitatges per planta

Evaluation of the prenatal diagnosis of limb reduction deficiencies. EUROSCAN Study Group.

Ultrasound scans in the mid-trimester of pregnancy are now a routine part of antenatal care in most European countries. Using data from registries of congenital anomalies a study was undertaken in Europe. The objective of the study was to evaluate prenatal detection of limb reduction deficiencies (LRD) by routine ultrasonographic examination of the fetus. All LRDs suspected prenatally and all LRDs (including chromosome anomalies) confirmed at birth were identified from 20 Congenital Malformation Registers from the following 12 European countries: Austria, Croatia, Denmark, France, Germany, Italy, Lithuania, Spain, Switzerland, The Netherlands, UK and Ukrainia. These registries are following the same methodology. During the study period (1996-98) there were 709,030 births, and 7,758 cases with congenital malformations including LRDs. If more than one LRD was present the case was coded as complex LRD; 250 cases of LRDs with 63 (25.2%) termination of pregnancies were identified including 138 cases with isolated LRD, 112 with associated malformations, 16 with chromosomal anomalies and 38 non chromosomal recognized syndromes. The prenatal detection rate of isolated LRD was 24.6% (34 out of 138 cases) compared with 49.1% for associated malformations (55 out of 112; p<0.01). The prenatal detection of isolated terminal transverse LRD was 22.7% (22 out of 97), 50% (3 out of 6) for proximal intercalary LRD, 8.3% (1 out of 12) for longitudinal LRD and 0 for split hand/foot; for multipli-malformed children with LRD those percentages were 46.1% (30 out of 65), 66.6% (6 out of 9), 57.1% (8 out of 14) and 0 (0 out of 2), respectively. The prenatal detection rate of LRDs varied in relation with the ultrasound screening policies from 20.0% to 64.0% in countries with at least one routine fetal scan.

Impact of Balanced or Unbalanced Karyotype At Diagnosis On Prognosis of CML: Long-Term Observation From 1346 Patients of the Randomized CML Study IV

Introduction: Acquired genetic instability in chronic myeloid leukemia (CML) as a consequence of the translocation t(9;22)(q34;q11) and the resulting BCR-ABL fusion causes the continuous acquisition of additional chromosomal aberrations and mutations and thereby progression to accelerated phase (AP) and blast crisis (BC). At least 10% of patients in chronic phase (CP) CML show additional alterations at diagnosis. This proportion rises during the course of the disease up to 80% in BC. Acquisition of chromosomal changes during treatment is considered as a poor prognostic indicator, whereas the impact of chromosomal aberrations at diagnosis depends on their type. Patients with major route additional chromosomal alterations (major ACA: +8, i(17)(q10), +19, +der(22)t(9;22)(q34;q11) have a worse outcome whereas patients with minor route ACA show no difference in overall survival (OS) and progression-free survival (PFS) compared to patients with the standard translocation, a variant translocation or the loss of the Y chromosome (Fabarius et al., Blood 2011). However, the impact of balanced vs. unbalanced (gains or losses of chromosomes or chromosomal material) karyotypes at diagnosis on prognosis of CML is not clear yet. Patients and methods: Clinical and cytogenetic data of 1346 evaluable out of 1544 patients with Philadelphia and BCR-ABL positive CP CML randomized until December 2011 to the German CML-Study IV, a randomized 5-arm trial to optimize imatinib therapy by combination, or dose escalation and stem cell transplantation were investigated. There were 540 females (40%) and 806 males (60%). Median age was 53 years (range, 16-88). The impact of additional cytogenetic aberrations in combination with an unbalanced or balanced karyotype at diagnosis on time to complete cytogenetic and major molecular remission (CCR, MMR), PFS and OS was investigated. Results: At diagnosis 1174/1346 patients (87%) had the standard t(9;22)(q34;q11) only and 75 patients (6%) had a variant t(v;22). In 64 of 75 patients with t(v;22), only one further chromosome was involved in the translocation; In 8 patients two, in 2 patients three, and in one patient four further chromosomes were involved. Ninety seven patients (7%) had additional cytogenetic aberrations. Of these, 44 patients (3%) lacked the Y chromosome (-Y) and 53 patients (4%) had major or minor ACA. Thirty six of the 53 patients (2.7%) had an unbalanced karyotype (including all patients with major route ACA and patients with other unbalanced alterations like -X, del(1)(q21), del(5)(q11q14), +10, t(15;17)(p10;p10), -21), and 17 (1.3%) a balanced karyotype with reciprocal translocations [e.g. t(1;21); t(2;16); t(3;12); t(4;6); t(5;8); t(15;20)]. After a median observation time of 5.6 years for patients with t(9;22), t(v;22), -Y, balanced and unbalanced karyotype with ACA median times to CCR were 1.05, 1.05, 1.03, 2.58 and 1.51 years, to MMR 1.31, 1.51, 1.65, 2.97 and 2.07 years. Time to CCR and MMR was longer in patients with balanced karyotypes (data statistically not significant). 5-year PFS was 89%, 78%, 87%, 94% and 69% and 5-year OS 91%, 87%, 89%, 100% and 73%, respectively. In CML patients with unbalanced karyotype PFS (p<0.001) and OS (p<0.001) were shorter than in patients with standard translocation (or balanced karyotype; p<0.04 and p<0.07, respectively). Conclusion: We conclude that the prognostic impact of additional cytogenetic alterations at diagnosis of CML is heterogeneous and consideration of their types may be important. Not only patients with major route ACA at diagnosis of CML but also patients with unbalanced karyotypes identify a group of patients with shorter PFS and OS as compared to all other patients. Therefore, different therapeutic options such as intensive therapy with the most potent tyrosine kinase inhibitors or stem cell transplantation are required.

Aixecament, anàlisi constructiu i projecte de reforma i canvi d'ús a l'escola de Saderra

L’objectiu principal és:Realització de l’aixecament de l’edifici existent.Recull de la informació històrica, necessària per conèixer lescaracterístiques de l’edifici.Estudi i catalogació de les diferents patologies que pateix l’edifici.Projecte de reforma i canvi d’ús per tal de que l’edifici doni un nou serveial municipi.A partir d’aquesta informació es determinarà, l’estat actual de l’estructura.A partir de l’estudi històric s’intentarà entendre la forma de construir de principis desegle i els diferents materials utilitzats.La realització de les fitxes de les diferents patologies que degraden l’edificació enspermetran l’actuació sobre aquestes i donar possibles solucions als fets que elsoriginen.El projecte de reforma i canvi d’ús s’intentarà donar un nou espai al municipi per tal deque la gent del poble i/o l’ajuntament en puguin treure algun profit

Projecte de rehabilitació d'un habitatge unifamiliar entre mitgeres "Cal Parent"

L’habitatge objecte d’aquest projecte final de carrera és anomenat popularment com a CalParent, i està situat al carrer Nou nº 15 del municipi de Biure, a la comarca de l’Alt Empordà. Ésuna típica edificació entremitgeres de poble, formada per planta baixa, planta pis, planta segonpis, terrat, i un pati a la part posterior de l’edifici.La façana principal està orientada al sud-oest i la façana posterior a nord-est, quedant lesaltres dues façanes que formen l’edifici en contacte amb els edificis veïns.Biure d’Empordà forma part de la comarca de l’Alt Empordà, província de Girona. Elterme municipal es troba a 81 m d’altitud i disposa d’una superfície de 10 Km2. Els límits delterme municipal són al nord amb Darnius i Capmany, a l‘est amb Masarac i Peralada, al sud ambCabanes i Pont de Molins i a l’oest amb Boadella d’Empordà

Prenatal diagnosis of dysmorphic syndromes by routine fetal ultrasound examination across Europe.

OBJECTIVES: Ultrasound scan in the mid-trimester of pregnancy is now a routine part of prenatal care in most European countries. The objective of this study was to evaluate the prenatal diagnosis of dysmorphic syndromes by fetal ultrasound examination. METHODS: Data from 20 registries of congenital malformations in 12 European countries were included in the study. RESULTS: There were 2454 cases with congenital heart diseases, 479 of which were recognized syndromes, including 375 chromosomal anomalies and 104 syndromes without chromosomal anomalies. Fifty-one of the 104 were detected prenatally (49.0%). One hundred and ninety-two of 1130 cases with renal anomalies were recognized syndromes, including 128 chromosomal anomalies and 64 syndromes without chromosomal anomalies; 162 of them (84.4%) were diagnosed prenatally, including 109 chromosomal anomalies and 53 non-chromosomal syndromes. Fifty-four of the 250 cases with limb defects were recognized syndromes, including 16 chromosomal syndromes and 38 syndromes without chromosomal anomalies; 21 of these 54 syndromes were diagnosed prenatally (38.9%), including 9 chromosomal syndromes. There were 243 cases of abdominal wall defects including 57 recognizable syndromes, 48 with omphalocele and 9 with gastroschisis; 48 were diagnosed prenatally (84.2%). Twenty-six of the 187 cases with diaphragmatic hernia had recognized syndromes, including 20 chromosomal aberrations and 6 syndromes without chromosomal anomalies. Twenty-two of them (84.6%) were detected prenatally. Sixty-four of 349 cases with intestinal anomalies were recognized syndromes; 24 were diagnosed prenatally (37.5%). There were 553 cases of cleft lip and palate (CL(P)) and 198 of cleft palate (CP) including 74 chromosomal anomalies and 73 recognized non-chromosomal syndromes. Prenatal diagnosis was made in 51 cases of CL(P) (53.7%) and 7 of CP (13.7%). Twenty-two of 188 anencephalic cases were syndromic and all were diagnosed prenatally. Of 290 cases with spina bifida, 18 were recognized syndromes, and of them 17 were diagnosed prenatally. All 11 syndromic encephaloceles were diagnosed prenatally. CONCLUSIONS: Around 50% of the recognized syndromes which are associated with major congenital anomalies (cardiac, renal, intestinal, limb defects, abdominal wall defects and oral clefts) can be detected prenatally by the anomaly scan. However the detection rate varies with the type of syndrome and with the different countries' policies of prenatal screening.

Extra-articular knee resection for a secondary chondrosarcoma evolving from an isolated enchondroma of the distal femur: A case report.

Introduction: Enchondromas are among the most current benign bone tumours. Malignant degeneration is extremely rare (<1%) and generally presents as a low grade chondrosarcoma. For localized grade 1 lesions, the treatment of choice is curettage. Wide excision and reconstruction is generally not necessary, unless locally advanced or more aggressive behaviour is suspected at presentation. Case report: A healthy 72 yo male presented with pain and recurrent knee joint effusion. X-rays show a classical central distal metaphyseal enchondroma of the femur associated with subtle osteolysis of the lateral condyle. MRI confirms the presence of a locally aggressive chondromatous lesion based in a classical enchondroma. Core needle biopsy revealed a grade 1 chondrosarcoma, which was in contrast to the radiological aggressiveness of the lesion. Total body CT-scan did not reveal metastatic disease. A wide resection was planned, as a high-grade lesion and joint contamination was suspected. We performed an extra-articular knee resection and reconstruction with a hinged modular total knee megaprosthesis. The definitive histology was grade 1 chondrosarcoma, the surgical margins were wide. The evolution was favourable and the patient was able to perform all his activities of daily living independently without pain at 6 weeks postop. Knee flexion reached 90°. The oncologic screening at 18 months did not show local or distant recurrence. Conclusion: Joints near a benign tumour that suddenly become symptomatic or present an effusion might indicate a malignant transformation. Wide resection and prosthetic reconstruction remains an effective treatment option even in low grade cartilaginous lesions if (1) the adjacent joint is contaminated, or (2) joint-sparing surgery would result in a severe functional impairment of the limb.

Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.

Primary rib involvement accounts for 16% of paediatric Ewing sarcoma (ES). Neo-adjuvant chemotherapy and surgical tumor resection may leave large thoracic wall defects requiring complex reconstruction in a growing individual. We report our experience in three children aged 3, 10, and 12 years, in whom single-stage resection and reconstruction were performed using a Gore-Tex Dualmesh patch, covered by a latissimus dorsi rotation flap harvested in continuity with the thoracolumbar fascia. The youngest patient also had a vertical expandable prosthetic titanium rib (VEPTR) anchored to help prevent subsequent scoliosis throughout growth.

Projecte d'interiorisme del Mas Carrera de Mieres

L'objecte del present document és la redacció del projecte per a la rehabilitació i el disseny d’interiors del conjunt edificat del Mas Carrera de Mieres per tal d'establir les condicions tècniques i administratives necessàries per a dur a terme la rehabilitació d’aquesta edificació tradicional, per tal d’adaptar-la a l’ús d’habitatge d’acord amb els requeriments d’habitabilitat vigents. La intervenció proposa recuperar la identitat del cos principal de can Carrera respectant la seva volumetria per tal de destinar-lo a l’habitatge principal, assignar als coberts i palleres annexos a usos complementaris tals com un estudi i una habitatge per a convidats, i garatge. El criteri d’intervenció bàsic és el respecte de les característiques i peculiaritats de les edificacions existents amb la identificació dels elements significatius i la seva adequació al nou programa d’habitatge a introduir d’acord amb els requeriments que aquest exigeix segons criteris de sostenibilitati adaptació al medi on s’emplaça

Unexpected findings on the taxonomic status of Est Mediterranean Crocidura russula auct. (Mammalaia, Insectivora)

With an approach, based on chromosomal, biochemical and morphological analysis, we show that the animals wich are classically attributed to C. r. gueldenstaedti and/or to C. r. monacha belong in fact to the taxon C. suaveolens. The oriental forms, formely seen as C. russula, are of the same karyotype as C. suaveolens and are biochemically close to C. suaveolens in Central Europe. The origin of the taxonomical confusion might stem from the large morphological variation in and between populations of C. suaveolens in the Near East. Based on our results C. russula monacha Thomas, 1906 belongs to the polymorphic species C. suaveolens Pallas, 1811 and we propose to consider C. (russula) gueldenstaedti Pallas, 1881 as "incertae sedis".