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Skull reconstructive surgery is critical to prevent cerebrospinal fluid (CSF) fistulas and infections, and to ensure good aesthetic results in meningiomas surgery.

Presentación de un caso de necrosis aséptica de cabeza de fémur izquierdo que después de 3 años de evolución presentó una agravación importante con pérdida de la interlínea y gran osteofitosis. Se propuso una intervención quirúrgica con colocación de prótesis total de cadera. La intervención fue rechazada por el paciente que decidió seguir con la medicación homeopática con el concurso de otras terapias complementarias (psicólogo, fisioterapeuta y nutricionista). Tuvo una evolución favorable con recuperación lenta, importante y progresiva que permitió la incorporación al trabajo y que no necesitó la solución quirúrgica propuesta.

Although many studies have evaluated the diagnostic reliability of store-and-forward (SF) teledermatology, the reliability of the technique for the diagnosis of general skin conditions in a clinical practice setting has never been demonstrated. We evaluated the reliability of SF teledermatology in clinical practice by analyzing the diagnostic agreement achieved in a subgroup of patients from the DERMATEL-2 study.

Aunque existen múltiples estudios de fiabilidad diagnóstica en teledermatología de almacenamiento (TDA), aún no se ha demostrado una fiabilidad elevada para enfermedad general cutánea en un escenario real. DERMATEL-2 fue un estudio aleatorizado de concordancia diagnóstica en TDA en condiciones de práctica clínica.

The article presents research which explores the causes and effects which led to ghost towns in Spain, particularly the ones surrounding the city if Madrid. It is noted that the research entitled "The City That Never Was" was conducted by the author and Christopher Marcinkoski, a professor specialized in landscapes and urban planning. It mentions Spain's housing development spurred by its entrance into the European Union, its urban policy, and the negative effects of the economic crisis starting in 2008.

Every part of Calophyllum inophyllumL. has been used in various traditional remedies, especially the oil from its nut was mostly used to treat skin diseases. This study aimed to investigate the composition and antioxidant activity of C. inophyllumnut oil and formulate the oil as a cosmeceutical product. The chemical composition and the amount of total phenolic compounds (TPC) were demonstrated by Gas Chromatograph-Mass Spectrometer (GC-MS) and Folin–Ciocalteu method, respectively. Additionally, the antioxidant activity was tested using the DPPH method. Calophyllolide (4.35%) was a major component. Additional components were calanolide A, inophyllum D, and inophyllum B. We found that the TPC contained 25.9 ± 1.2 mg GE/g oil and a free radical scavenging activity approximate to that of the synthetic Trolox. Emulgel formulation consisted of tween 80, span 80, and isopropyl alcohol as a surfactant, and carbopol 940 as a gelling agent. The microemulsion was formulated using distilled water, oil, tween 80 with span 80, as a surfactant, and isopropyl alcohol as a cosurfactant. The mean droplet size for optimized microemulsion formulations was 34.37 ± 1.06 nm. Furthermore, the results of thermodynamic stability tests (freeze-thaw cycle) and long-term stability tests indicated that emulsions and microemulsions remained stable. In conclusion, this nut oil could potentially be used as a cosmeceutical product, and the obtained emulgels and microemulsions exhibited good characteristics in terms of being a potential agent for skin antioxidant.

Purpose. To report the efficacy and ocular tolerance of a new tamponade made with ether and silicone oil (HeavySil [HSIL]) for the treatment of retinal detachment (RD) complicated by inferior proliferative vitreous retinopathy (PVR).Methods. Prospective noncomparative interventional study on 31 consecutive eyes that underwent pars plana vitrectomy and were treated with HSIL as an intraocular tamponade. All patients presented with at least one retinal break and grade B–C PVR located between 4 and 8 o'clock. The main endpoint criteria were retinal reattachment after the removal of HSIL and complications arisen from the use of this tamponade.Results. Primary anatomic success was achieved in 27 out of 31 cases. Mean visual acuity improved from logMAR 1.4 (SD 0.7) to logMAR 1.1 (SD 0.6) (p=0.02). The main complications reported were cataract formation (5 out of 7 phakic eyes cases), clinically visible emulsification (6 cases), and difficulty of oil removal in 3 cases. Severe intraocular inflammation with HSIL in situ was found in only one case.Conclusions. HeavySil, a saturated solution of ether with silicone oil, is a safe and effective tamponade agent for the treatment of complicated RD. The most common complications are cataract formation and oil emulsification.

Watermelon consumption results in generation of organic waste in the form of seeds and peels. We have evaluated the fatty acid profiles and antioxidant content of watermelon (Kinnaree cultivar) seed oil and peel wax. In addition, we assessed the potential use of these watermelon industry byproducts in the development of cosmeceuticals. The most abundant fatty acids in seed oil and peel wax were linoleic acid and arachidic acid, respectively. Fatty acids form an essential component in the cell membranes and have seen increased recognition in the cosmeceutical industry. Antioxidants also play a beneficial role in skincare in combating free-radicals resulting from sun damage and pollutants. The seed oil showed stronger antioxidant activity than the peel wax, as indicated by the DPPH radical scavenging ability of 0.894 mg α-tocopherol equivalent/g dried seeds versus 0.036 mg α-tocopherol equivalent/g dried peels. Therefore, the seed oil was formulated into skincare products, in the form of emulsions and nanoemulsions. The most effective formulae were stable at room temperature for seven days, or following repeated cycles of heating and cooling. This work demonstrates the potential for watermelon seed oil to be employed in skincare product formulations, which could maximize agricultural profit and minimize environmental waste.

The purpose of this paper is to provide an insight into entrepreneurial orientation, market orientation and internationalisation in born global small and micro-businesses in Ireland, when owner-manager perceptions are taken into account. Following an exploration of the major theoretical approaches of SME internationalisation and performance, and entrepreneurial/market orientations, a qualitative study is undertaken on owner-managers of four born global firms to present a conceptual model. Although there are a number of studies on born global firms and extensive research on entrepreneurial and market orientations, this study proposes to combine internationalisation and orientation approaches in studying small and micro-businesses. Future studies could empirically test the proposed new conceptual model within a large sample.

Despite the widespread use of free perforator flaps, pedicled perforator flaps seem not to be as widely accepted, probably because of the fear of vascular complications caused by transfer of a flap attached only by its vascular pedicle, prone to shearing, kinking, and trauma. In this article, the authors report on their experience with 85 consecutive cases, focusing on incidence, prevention, and management of complications.

Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of these defects with local tissue is presented in this article that uses superficial musculoaponeurotic system (SMAS) plication to allow wide advancement of a cervicofacial flap.

Over the past few years, the use of propeller flaps, which base their blood supply on subcutaneous tissue or isolated perforators, has become increasingly popular. Because no consensus has yet been reached on terminology and nomenclature of the propeller flap, different and confusing uses of the term can be found in the literature.

The interaction of spores of Ulvawith bioinspired structured surfaces in the nanometer–micrometer size range is investigated using a series of coatings with systematically varying morphology and chemistry, which allows separation of the contributions of morphology and surface chemistry to settlement (attachment) and adhesion strength. Structured surfaces are prepared by layer‐by‐layer spray‐coating deposition of polyelectrolytes. By changing the pH during application of oppositely charged poly(acrylic acid) and polyethylenimine polyelectrolytes, the surface structures are systematically varied, which allows the influence of morphology on the biological response to be determined. In order to discriminate morphological from chemical effects, surfaces are chemically modified with poly(ethylene glycol) and tridecafluoroctyltriethoxysilane. This chemical modification changes the water contact angles while the influence of the morphology is retained. The lowest level of settlement is observed for structures of the order 2 µm. All surfaces are characterized with respect to their wettability, chemical composition, and morphological properties by contact angle measurement, X‐ray photoelectron spectroscopy, scanning electron microscopy, and atomic force microscopy.

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Purpose. Thiols are sulfhydryl-containing organic compounds that have an important role in preventing cellular oxidative stress. This study compares the blood oxidative stress marker levels in bronchiectasis cases during their stable periods with healthy controls. Materials and Methods. Seventy-seven patients (49 patients with stable bronchiectasis/28 healthy controls), followed up by the chest disease clinic, were included in the study. Peripheral blood thiol-disulfide parameters (NT: native thiol (−SH); TT: total thiol (−SH + SS); SS: disulfide (−SS); SS-SH: disulfide/native thiol index; SS-TT: disulphide/total thiol index; SH-TT: native thiol/total thiol index), and ischemia-modified albumin (IMA) levels were examined in the stable bronchiectasis group and the control group. Thiol-disulfide homeostasis was evaluated using a novel and automated assay. Findings and Result. Blood native thiol levels in patients with stable bronchiectasis were found to be significantly higher compared with healthy controls. A positive correlation between the total airway disease score and IMA levels was present. Our findings revealed that native thiol levels, which constitute a part of the antioxidant defense system, are increased in patients with stable bronchiectasis.

Las ataxias hereditarias (AH) y paraparesias espásticas hereditarias son enfermedades raras, poco frecuentes en las consultas del neurólogo general. Proponemos una guía práctica y breve de diagnóstico y manejo de estos pacientes, así como un procedimiento para la evaluación integrada del grado de su discapacidad. Se describen por apartados los conceptos y definiciones de AH y AH-plus y paraparesias espásticas hereditarias pura y complicada, la valoración clínica de los pacientes con las principales pruebas complementarias a realizar, las escalas clínicas necesarias para poder graduar la condición física y psíquica de los pacientes, y se resumen los tratamientos disponibles. Esta guía pretende facilitar la asistencia clínica diaria por parte del neurólogo y unificar los criterios médicos y la metodología de evaluación de la discapacidad de los pacientes con AH y paraparesias espásticas hereditarias.

The supraclavicular skin has been studied extensively and used as a pedicled flap for face and neck reconstruction. Its use as a free flap has not paralleled its use as a pedicled flap. The authors performed an anatomical investigation to assess the possibility of harvesting a free supraclavicular flap with the donor-site scar lying in the supraclavicular crease. In this article, the authors present the results of their anatomical study together with the preliminary clinical applications.

Macrophages have the capacity to proliferate in response to specific growth factors, such as macrophage-colony stimulating factor (M-CSF). In the presence of several cytokines and activating factors, macrophages undergo growth arrest, become activated, and participate in the development of an immune response. We have previously observed that activation of extracellularly regulated kinase 1/2 (ERK-1/2) is required for macrophage proliferation in response to growth factors. A short and early pattern of ERK activity correlated with the proliferative response. In contrast, slightly prolonged patterns of activity of these kinases were induced by signals that lead to macrophage activation and growth arrest. IFN-γ is the main endogenous Th1-type macrophage activator. Here we report that stimulation with IFN-γ prolongs the pattern of ERK activity induced by M-CSF in macrophages. These effects correlate with IFN-γ–mediated inhibition of the expression of several members of the MAPK phosphatase family, namely MKP-1, -2, and -4. Moreover, inhibition of MKP-1 expression using siRNA technology or synthetic inhibitors also led to elongated ERK activity and significant blockage of M-CSF–dependent proliferation. These data suggest that subtle changes in the time course of activity of members of the MAPK family contribute to the antiproliferative effects of IFN-γ in macrophages.

Telemedicine refers to the use of telecommunications technology to provide health care and medical information. The practice of medicine—and dermatology in particular—is undergoing a great upheaval due to advances in information technology. This article briefly reviews the origin, development, applications, benefits, methodology, and components of telemedicine. Specifically, we will analyze the types and applications of teledermatology, paying particular attention to technical, organizational, and legal aspects.

BACKGROUND Both dominant and recessive mutations were reported in the gene encoding the mitochondrial (mt) DNA polymerase γ (POLG) in patients with progressive external ophthalmoplegia (PEO). Phenotypes other than PEO were recently documented in patients with mutations in the POLG gene. OBJECTIVE To screen patients with mitochondrial disease and multiple mtDNA deletions in muscle for mutations in the coding regions of the POLG, PEO1, and SLC25A4genes. DESIGN To identify the underlying molecular defect in a group of patients with multiple mtDNA deletions comparing their molecular genetic findings with those of healthy controls. PATIENTS Twenty-four patients (16 men and 8 women) diagnosed with mitochondrial disease and having multiple mtDNA deletions in muscle by Southern blot analysis. Thirteen patients had PEO; 2 had PEO alone, 4 had PEO and myopathy, and 5 had PEO and multisystem involvement. Four patients had multisystem disease without PEO. The remaining 9 patients had isolated myopathy. DNA from 100 healthy individuals was also studied. RESULTS No mutation was identified in the PEO1 or SLC25A4 genes. Nine POLG mutations were observed in 6 of 24 patients. Four novel mutations were detected and mapped in the linker region (M603L) and in the pol domain of the enzyme (R853W; D1184N; R1146C). Five patients with PEO had mutations: 2 were compound heterozygotes, 1 was homozygous, and another showed a mutation in a single allele. The remaining patient also showed a sole mutation and had an unusual phenotype lacking ocular involvement. CONCLUSIONS POLG molecular defects were found in 25% of our patients with multiple mtDNA deletions and mitochondrial disease. The uncommon phenotype found in 1 of these patients stresses the clinical variability of patients harboring POLG mutations. Molecular studies in the POLG gene should be addressed in patients with mitochondrial disease, particularly in those with PEO, and multiple mtDNA deletions.Arch Neurol. 2006;63:107-111 --

The association between factor VII deficiency and cleft palate has never been described. The case of a child with cleft palate and factor VII deficiency who successfully underwent palatoplasty is described in this article. To allow surgical treatment, through maintenance of a normal prothrombin time, the patient was given 15 µg/kg of recombinant factor VIIa every 12 hours, starting 20 minutes before surgery and ending the third postoperative day. No abnormal perioperative bleeding was observed. Use of recombinant factor VIIa in bleeding prophylaxis or treatment is widespread. Doses are much higher in these cases. The reduction of dosage allows easier administration, especially in pediatric patients, without affecting drug efficacy.

Previous studies identified a small fraction of putatively sumoylated topoisomerase I (TOP1) under basal conditions ( approximately 1%), and anticancer camptothecins that trap the TOP1-DNA covalent intermediate markedly increase the sumoylation of TOP1 (

Protein structures can be encoded into binary sequences (Gabarro‐Arpa et al., Comput Chem 2000;24:693–698) these are used to define a Hamming distance in conformational space: the distance between two different molecular conformations is the number of different bits in their sequences. Each bit in the sequence arises from a partition of conformational space in two halves. Thus, the information encoded in the binary sequences is also used to characterize the regions of conformational space visited by the system. We apply this distance and their associated geometric structures to the clustering and analysis of conformations sampled during a 4‐ns molecular dynamics simulation of the HIV‐1 integrase catalytic core. The cluster analysis of the simulation shows a division of the trajectory into two segments of 2.6 and 1.4 ns length, which are qualitatively different: the data points to the fact that equilibration is only reached at the end of the first segment. The Hamming distance is compared also to the r.m.s. deviation measure. The analysis of the cases studied so far shows that under the same conditions the two measures behave quite differently, and that the Hamming distance appears to be more robust than the r.m.s. deviation. Proteins 2002;47:169–179. © 2002 Wiley‐Liss, Inc.

A wide variety of adsorbents has been reported in the literature for heavy metal adsorption. We have recently developed a new polymer system for the removal of contaminant heavy metal ions from aquatic systems. Thus, poly(hydroxyethylmethacrylate) (PHEMA) microbeads carrying thiazolidine (0.318 mmol/g) were prepared for the removal of different amounts of mercury(II) ions (50–900 mg/l) from aqueous solutions and at different pH values (3.0–7.0). Adsorption rates were high with adsorption equilibria being reached within 10 min. The adsorption of Hg(II) ions on to the thiazolidine-immobilized microbeads from single solutions amounted to 1.11 mmol/g. The formation constant of the thiazolidine–metal ion complex was investigated by the method of Ružić. The calculated value of the stability constant was 9.11 × 105l/mol for the Hg(II)–thiazolidine complex. PHEMA microbeads carrying thiazolidine may be regenerated by washing with a solution of hydrochloric acid (0.05 M). The maximum desorption ratio was as high as 99%. These PHEMA microbeads may be used repeatedly for more than three adsorption/desorption cycles without any considerable loss in adsorption capacity.

Magnetic poly(vinyl alcohol) (mPVAL) gel beads (150–200 μm in diameter) carrying Procion Blue MX-3G (122 μmol/g) were used for the removal of different amounts (50–650 mg/l) of Hg(II) ions from aqueous solutions. The mPVAL gel beads were characterized by swelling tests, electron spin resonance (ESR), elemental analysis and scanning electron microscopy (SEM). The swelling ratio of the mPVAL gel beads, which had a spherical shape and porous structure, was 76%. The presence of magnetite particles in the polymeric structure was confirmed by ESR spectroscopy. The capacity of the beads towards Hg(II) ions increased with time during the first 10 min of adsorption and then levelled off towards an equilibrium adsorption capacity. The adsorption of Hg(II) ions on the plain beads was very low (0.57 mg/g) but increased substantially (to 69.2 mg/g) on beads to which Procion Blue MX-3G had been attached.The Langmuir adsorption isotherm was applicable to the description of Hg(II) ion adsorption by Procion Blue MX-3G-attached mPVAL gel beads. Such adsorption increased with increasing pH of the aqueous medium and reached a plateau level at ca. pH 6.0. The optimal pH range for Hg(II) ion adsorption was 6.0–7.0.More than 95% of the adsorbed Hg(II) ions was desorbed within 15 min when 0.1 M HNO3was used as an elution agent. Regeneration of the Procion Blue MX-3G-attached mPVAL gel beads under these conditions was also reasonable.

Melatonin has been shown to act as a radical scavenger in various chemical and biological model systems in vitro. Kinetic evidence is now provided showing that melatonin inhibits the irreversible degradation of hemoglobin (Hb), when incubated with red blood cells exposed to the oxidant activity of cumene hydroperoxide (cumOOH). A decrease of heme loss and accumulation of soluble methemoglobin (met‐Hb) are explained in terms of the interaction of the indoleamine with perferryl Hb (⋅Hb[FeIV=O]), a highly reactive Hb‐derived radical species responsible for the irreversible Hb degradation. A kinetic study, in pure chemical solution, showed that melatonin can effectively reduce the oxoferryl heme group of perferryl‐Hb, thus forming met‐Hb. The reducing activity of melatonin is of the same order as that of Trolox, the water‐soluble vitamin E analog. This novel radical‐scavenging activity of melatonin may contribute to the previously observed protective effects of melatonin in ischemia‐reperfusion injury.

We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electro-oculographic (EOG) evaluation. (There have been no cases of serious phenytoin toxicity seen in our department since August 1989.) In addition to EOG, all patients had undergone otoscopic, audiometric, and neurologic examinations. We found that the most common pathologic findings detected by EOG were abnormalities in pursuit tracking. The most common signs found on clinical exploration were cerebellar dysfunction and facial palsy. EOG findings in patients with phenytoin toxicity are compatible with cerebellar disease.

Fifteen β-thalassemia intermedia patients, not requiring chronic transfusional therapy, were monitored in order to check their antioxidant status, and the lipid oxidation products in plasma, LDL, and erythrocytes before and during a 9-month oral treatment with 600 mg/day vitamin E. The low level of vitamin E, and high level of malondialdehyde in plasma clearly tended to normalize after three months (P<.001), and were quite similar to control after six months. The abnormally low level of vitamin E in LDL and the four times higher than control basal level of conjugated dienes (LDL-CD), were not modified after three months of treatment. Significant changes of LDL-VE (P<.05) and of the basal LDL-CD (P<.001) were evident after six months. LDL-VE was within the normal range after nine months, whereas LDL-CD still appeared twice as higher than control.Plasma vitamin A, ascorbate, β-carotene, and lycopene increased markedly at the end of the trial (P<.005).The level of vitamin E in red blood cells was normalized after six months of supplementation. A decrease of the baseline value of conjugated dienes was observed after nine months, although it remained 1.4-fold higher than control. The RBC count and hematocrit appeared higher at the end of the trial (P<.05 and P<.001, respectively). The hemoglobin value did not show variations. A shift to normal of the resistance of erythrocytes to osmotic lysis was observed.Our findings provide evidence that an oral treatment with vitamin E improves the antioxidant/oxidant balance in plasma, LDL particles, and red blood cells, and counteracts lipid peroxidation processes in β-thalassemia intermedia patients.

Reaction of melatonin with the hypervalent iron centre of oxoferryl hemoglobin, produced in aqueous solution from methemoglobin and H2O2, has been investigated at 37°C and pH 7.4, by absorption spectroscopy. The reaction results in reduction of the oxoferryl moiety with formation of a heme-ferric containing hemoprotein. Stopped-flow spectrophotometric measurements provide evidence that the reduction of oxoferryl-Hb by melatonin is first-order in oxoferryl-Hb and first-order in melatonin. The bimolecular reaction constant at pH 7.4 and 37°C is 112 ± 1.0 M-1 s-1.Two major oxidation products from melatonin have been found by gas chromatography-mass spectroscopy: the cyclic compound 1,2,3,3a,8,8a-hexahydro-1-acetyl-5-methoxy-3a-hydroxypyrrolo[2,3-b]indole (cyclic 3-hydroxy-melatonin), and N-acetyl-N'-formyl 5-methoxykynuramine (AFMK). The percentage yield of the two major products appears dependent on the ratio [oxoferryl-Hb]: [melatonin] - the higher the ratio the higher the yield of AFMK. The observed stoichiometry oxoferryl-Hbreduced:melatoninconsumed is 2, when the ratio [oxoferryl-Hb]:[melatonin] is 1:1, but appears >2 at higher molar ratios. The reduction of the hypervalent iron of the oxoferryl moiety may be consistent with an oxidation of melatonin by two one-electron steps.

The aim of this controlled clinical study, performed in a specialized institutional unit for thalassaemic men, was to consider the possibility of restoring erection in beta-thalassaemic patients with erectile dysfunction by administering E(1) prostaglandins (alprostadil) transurethrally. Four patients affected by beta-thalassaemia, aged between 32 and 52 years, and having an erectile dysfunction were included in the study. Each patient was given 500 microg alprostadil in the distal urethra. Response was evaluated by the erection assessment scale. The main outcome measures were: (i) the clinical study; (ii) FSH, LH, total and free testosterone plasma concentrations; and (iii) basal and dynamic Doppler sonography of cavernous arteries. The treatment produced a response of 3-4 on the erection assessment scale. Average minimum response time was 20 min, while average maximum response time was about 60 min. There was no evidence of significant side effects. Our hypothesis is that the delayed reaction was due to organ damage induced by iron load, causing a reduction or absence of elasticity in the interstitial tissue of the corpora cavernosa. Thus, we believe that treatment with alprostadil can be considered an effective, non-invasive therapy for thalassaemic patients with erectile dysfunction.

The aim of this controlled clinical study, performed in a specialized institutional unit for thalassaemic men, was to consider the possibility of restoring erection in β-thalassaemic patients with erectile dysfunction by administering E1 prostaglandins (alprostadil) transurethrally. Four patients affected by β-thalassaemia, aged between 32 and 52 years, and having an erectile dysfunction were included in the study. Each patient was given 500 μg alprostadil in the distal urethra. Response was evaluated by the erection assessment scale. The main outcome measures were: (i) the clinical study; (ii) FSH, LH, total and free testosterone plasma concentrations; and (iii) basal and dynamic Doppler sonography of cavernous arteries. The treatment produced a response of 3–4 on the erection assessment scale. Average minimum response time was 20 min, while average maximum response time was about 60 min. There was no evidence of significant side effects. Our hypothesis is that the delayed reaction was due to organ damage induced by iron load, causing a reduction or absence of elasticity in the interstitial tissue of the corpora cavernosa. Thus, we believe that treatment with alprostadil can be considered an effective, non-invasive therapy for thalassaemic patients with erectile dysfunction.

Abstract The objectives of this study were to evaluate the clinical and electrophysiological findings in peroneal mononeuropathies following a weight‐reduction diet. Thirty patients with acute peroneal palsy and weight loss were studied. Complete nerve conduction studies (NCS) were performed in upper and lower limbs. NCS showed conduction block (CB) of the peroneal nerve at the fibular head that recovered in 29 patients within 3 weeks to 3 months. Severity of CB was correlated with clinical weakness. Three patients had abnormalities consistent with polyneuropathy (PNP). NCS in asymptomatic relatives confirmed familial neuropathy. Nerve biopsy and molecular study were consistent with hereditary neuropathy with liability to pressure palsies (HNPP). One of these peroneal palsies (6 months) recovered after neurolysis. Weight loss might be a risk factor in peroneal mononeuropathies. NCS is a tool in the diagnosis of the site and severity of the nerve injury. Testing should be considered for relatives of patients with PNP because peroneal mononeuropathies may be the first expression of HNPP.