A methodology to evaluate the optimal insulation thickness for heating and cooling needs in different climatic zones for buildings made of reinforced concrete with cavity walls.

The study aims to define a methodology to evaluate the optimal insulation thickness with reference to the annual energy balance, including both heating and cooling seasons, for different climatic zones, based on three real case studies. The reduction of the heating needs due to the insulation of walls in places with cold climates is a consolidated concept. However, the effects of a high level of insulation of the envelope on the cooling needs has not yet been deeply analysed. The heating and cooling needs have been computed according to UNI/TS 11300 Italian standard by means of a commercial numerical model, varying the sizes of the buildings, the climatic zone, and the level of insulation. All the simulations concern buildings made of reinforced concrete frames with cavity walls, because of their wide diffusion as typical building technology of post war constructions. The work highlights the negative impact of the coating on the cooling needs, especially in the climatic zones with lower degree days. In almost all the climatic zones, the cooling need decreases its peaks during the hottest months (e.g., July or August), while the monthly load increases in the mild months (e.g., May, September) due to the additional thermal load which is no longer dispersed by means of the envelope. In conclusion, a range of optimal thicknesses for insulation for the different Italian climatic zones has been identified based on the total energy need of the building (cooling and heating).

Correction to: Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases.

An amendment to this paper has been published and can be accessed via the original article.

Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases.

BACKGROUND: Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable. A meeting was held in Vilnius, Lithuania (March 23, 2018) under the patronage of the Ministry of Health and several scientific societies to propose multisectoral care pathways embedding guided self-management, mHealth and air pollution in selected chronic respiratory diseases (rhinitis, chronic rhinosinusitis, asthma and COPD). The meeting resulted in the Vilnius Declaration that was developed by the participants of the EU Summit on chronic respiratory diseases under the leadership of Euforea. CONCLUSION: The Vilnius Declaration represents an important step for the fight against air pollution in chronic respiratory diseases globally and has a clear strategic relevance with regard to the EU Health Strategy as it will bring added value to the existing public health knowledge.

[Chromomycosis by Rhinocladiella aquaspera: The first case in Venezuela.]. / Cromomicosis por Rhinocladiella aquaspersa: descripción del primer caso en Venezuela.

A case of chromomycosis induced by Rhinocladiella aquaspersa is decribed in Falcon State, which is considered as the first case in Venezuela, and the fifth one in the whole world of this species of Rhinocladiella. The case was observed in a five year-old child from the south part of Falcon State. The child presented wounds of two years of duration, in his upper left limb. These wounds were characterized by queloide cicatrices, and contiguous nodules, with a scalyo-scab surface. The disease was diagnosed through direct observation of cells extracted from the wounds and cleared with potassium hydroxide at 10%. The identification of R. aquaspersa was made by 1) The isolation in culture, using Lactritmel, Sabouraud-agar and Sablac as culture media; and 2) By observation, in slide culture, of dissemination structures characterized by erect conidiophores which were either simple or branched. The thermo-tolerance test applied indicate an optimum development temperature of 28 degrees C. It was not possible to reproduce the illness in Balb/c mice. The patient showed an unsatisfactory response to Itraconazol medication and improvement to an external local application therapy. Up to the present time, 370 cases of chromomycosis have been studied in Falcon State, with 21 cases in children. The suggests the existence of a susceptibility to this kind of mycosis from childhood.

Kartagener's syndrome in a woman with a normal ciliary structure and an intracranial meningioma.

Kartagener's syndrome is usually associated with ciliary abnormalities. We describe a case of Kartagener's syndrome observed in a woman with an intracranial meningioma and a normal axonemal structure. This finding confirms that ultrastructural defects of bronchial cilia are not always present in Kartagener's syndrome.

[Mycosis: a therapeutic breviary, 1985]. / Micosis: breviario terapéutico, 1985.

A short, up to date review of the therapy of the mycoses makes it clear that almost every case of almost every mycoses can be treated until eradication. On the other hand, the diagnostic facilities and the therapeutic expertise of the physicians and the socio-economic and mental capacity of most patients are insufficient for a substantial change to be attained.

[Taeniolella boppi, a new species, causative agent of chromomycosis]. / "Taeniolella boppii", nova species, agente de cromomicosis.

The holotype is described of a new species of chromomycetes, that was isolated by Prof. Clovis Bopp (Porto Alegre, Rio Grande do Sul, Brasil) from lesions of chromomycosis in the inferior limb of a woman. The binomium Taeniolella boppii is proposed for the new taxon. The whole mycelium is dark. The culture surface is velvetyyowdery, folded into a few forrows, at first olive green later on olive black in color. The macro-culture's diameter grows 1,5 mm. a day. The minimum growing temperature lies at 10, the optimum one at 23-28 and the maximum one at 36 degrees C. The gelatin and the milk proteins are very slowly digested. The vegetative mycellum is made up of smooth, cylindrical hyphae, whose diameter measure, 2,25-3,75 m. From these toruloid hyphae are formed, simple or ramified whose cells measure 3-4 x 3-5 in size, and are smooth, continuous or 1-septate. Sometimes, bigger intercalary or terminal cells are seen that are ellypsoid and dictyoseptated and can measure until 14 m in diameter. No part of the mycellium secredes. By injecting Taeniolella boppii's cultures into peritoneum of white mice, into the derma of a voluntary, into the testes of a guinea-pig and into the plantar bursa of white mice, no progressive injection could be elicted; only an ephemeral germination of some toruloid cells but not the transformation to the chromomicetic parasitic form could be observed. The holotype is preserved in the mycologic collection of the medical faculty of Caracas at the position FMC 292.

[Cutis "trunci variata." A new genetic dermatosis]. / Cutis "trunci variata". Nueva genodermatosis.

A maculo-hypochromic condition is not rarely seen in brown-skinned adolescents and young adults, that may spread over the skin of the trunk, specially the lumbar, sacral and epigastric regions assuming a considerable psychologic important. It is generally confused with pityriasis versicolor or its hypochromic sequelae. The histologic and genetic study of the condition remains undone. It is provisionally considered among genodermatoses and the name cutis trunci variata is being proposed for it.

[Experience with homemade substrates for mycology]. / Experiencia con terrenos caseros para micología.

The meaning of the words "home-made", "medium" and "soil" is defined. The formulae are given and the manner for preparing lactritmel, lacmel and tritmel is described. The same for horse and cow dung agar soils is done. The lactritmel (20 fold diluted in water) is recommended for the specific diagnosis of Candida albicans in its nascent culture. The first results are communicated, as obtained by slide culturing fungi on banana (Musa paradisiaca) fruit pulp without previous sterilization. The amusing aspect of fungi-culturing is emphasized.

[Chromomycosis in Iberia]. / Cromomicosis en Iberia

A 66 year old, Spaniard, born at Sueca (Valencia Province), was found infected with "Fonsecaea pedrosoi". His lesion, located in the inner aspect of the right arm, appeared when he was 7-8 years old, and progressed very slowly until he migrated to Venezuela, at 42. Thereafter it progressed more rapidly and started to hurt. Treatment included administration of 5-flucytosine at the daily dose of 150 mg./kg. during 4 and a half months and thermotherapy by means of a permanent adhesive tape on the lesion during 6 months. Eleven months after completion of the treatment, the patient is asymptomatic. This is the second case of chromomycosis originating in the Iberian peninsula. The importance of climate, clothing and age is discussed with reference to epidemiology of chromomycosis. The isolated strain of "F. pedrosoi" is the first one from the same region: its cultural characteristics and virulence among mice are studied and reported with some details. We think that in Europe, and especially in the Mediterranean countries, cases of chromomycosis did possibly occur, which were labelled as tuberculosis verrugosa or vegetans pyoderma owing to their histological picture.

[Miconazole per os in tinea and deep mycosis]. / Miconazole per os en tiña y micosis profundas

For the last 6 years we have been using Miconazole cream in the treatment of tinea and vaginal candidiasis. We think that it is at least as good as the best drugs for this purpose, but consider it difficult to decide about its superiority. Therefore we refrain from describing this part of our experience in detail. We have employed Miconazole "per os" at the daily doses of 24-28 mg./kg. in treating 3 cases of tinea corporis or cruris by "Trichophyton rubrum". Symptoms ceased in 3 days; mycologic examination turned negative in 2 weeks; treatment ended in apparent cure in 3 weeks. We have employed Miconazole "per venam" and "per os" in the treatment of: mycetomata (2) by "Streptomyces somaliensis", without success; mycetoma by "Madurella grisea" (1), without success; chromomycosis by a 5-flucytosine resistant strain of "Cladosporium carrionii" (1), without success; paracoccidioidosis (5) with lesions in mouth and lungs, with good results; leishmaniasis by "Leishmania brasiliensis" (1), without success; mucocutaneous disseminated candidiasis (1), with very good results. Tolerance has been excellent: but pruritus appeared from the third week with 600 or more mg. "per venam", in several patients. Doses varied between 10 and 50 mg./kg./day. One patient, who suffered with candidiasis, is taking 50 to 30 mg./kg./day since more than a year ago and, being a child, he is feeling well and growing to be normal. We recommend employing Miconazole against systemic canidiasis, sulpharesistant paracoccidioidosis and assaying it further in tinea (at least, in griseofulvin-resistant cases).

[Chromoblastomycosis caused by a new species: Taeniolella boppii]. / Cromoblastomicose causada por nova especie. Taeniolélla boppii.

The authors report a case of a 51-year-old woman, living in the extreme west of the Santa Catarina State (South of Brazil, near the Argentine border), who presented a vegetating plaque in the foot, associated with inflammatory nodules in the leg, according to the sporotrichoid form of chromoblastomycosis, with a histologic pattern distinct from the commonly observed. In culture the fungus produced exclusively and repeatidly colonies of a Cladosporium type. More detailed studies of the fungus made by Dante Borelli of Venezuela, proved it to be the type of a new species of Dematiaceous mould.