Adjacent Bi-Level Bilateral Pedicle Stress Fractures After Instrumented Posterolateral Lumbar Fusion - a Case Report and Review of the Literature

Isolated bilateral pedicle stress fractures of the lumbar spine are rare events, and few cases are reported in the literature. Their occurrence is commonly related to post-operative complications of spine instrumentation but can also be associated with stress-related activities, degenerative spine conditions, trauma and other miscellaneous causes. The authors report a case of adjacent bi-level bilateral pedicle fracture that developed 5 years after an instrumented posterolateral lumbar fusion. We believe that this has never been described before, and we reviewed the current literature pertaining this subject.info:eu-repo/semantics/publishedVersio

Compreender a Recorrência dos Mixomas Cardíacos. Um Caso Clínico

Recurrence of cardiac myxoma is a rare condition, observed in about 3% of patients in sporadic cases, although it is more frequent in familial ones. Several mechanisms have been proposed to explain such recurrence, and the importance of increased vascularization as a facilitating feature is the subject of debate. The authors report the case of a non-familial right atrial myxoma, unusual for both its histopathology and recurrence

Wickerhamomyces sylviae f.a., sp. nov., an ascomycetous yeast species isolated from migratory birds.

In the present work, we investigated the phylogenetic position and phenotypic characteristics of eight yeast isolates collected from migratory birds on the island of Ustica, Italy. A phylogenetic analysis based on the D1/D2 region of the large-subunit rRNA gene showed that all isolates clustered as a single separate lineage within the Wickerhamomyces clade. They exhibited distinct morphological and physiological characteristics and were clearly separated from their closest relatives, Wickerhamomyces lynferdii, Wickerhamomyces anomalus and Wickerhamomyces subpelliculosus, in BLASTN searches. On the basis of the isolation source, physiological features and molecular strain typing carried out with randomly amplified polymorphic DNA (RAPD)-PCR and minisatellite-primed (MSP)-PCR analysis, the isolates were identified as strains of the same species. The name Wickerhamomyces sylviae f.a., sp. nov. is proposed to accommodate these novel strains; the type strain is U88A2T (5PYCC 6345T5CBS 12888T). The MycoBank number is MB 804762

TANGO2 Deficiency Disorder: Two Cases of Developmental Delay Preceding Metabolic Crisis

Background: TANGO2 deficiency disorder is a rare genetic disease caused by biallelic defects in TANGO2 gene. Methods: We report the clinical phenotype of two children with TANGO2 deficiency disorder. Results: Patient 1 is a female child presenting with developmental delay and microcephaly during the second year of life, who evolved with severe cognitive impairment, facial dysmorphisms, spastic paraparesis, and atonic seizures. At age 13 years, she was hospitalized due to an episode of rhabdomyolysis complicated with cardiac arrhythmia and hypothyroidism. Patient 2 is a female child with dysmorphic facial features, cleft palate, and developmental delay who was diagnosed with DiGeorge syndrome. At age three years, she presented with an acute episode of severe rhabdomyolysis in the context of human herpesvirus 6 infection. After the resolution of this acute episode, she maintained recurrent muscle weakness with axial hypotonia and progressive spasticity of the lower extremities. In both patients, diagnosis of TANGO2 deficiency disorder was only confirmed after an acute metabolic crisis. Conclusions: A high index of suspicion for TANGO2 deficiency disorder is needed in patients with developmental delay or other neurological symptoms and episodic rhabdomyolysis.info:eu-repo/semantics/publishedVersio

Component digestibility of lupin (Lupinus angustifolius) and pea (Pisum sativum) seeds and effects on the small intestine and body organs in anastomosed and intact growing pigs.

Thirty-six male growing pigs were used to compare the component digestibility of legume seeds and the impact of diets and ileo-rectal anastomosis (IRA) on the morphology and enzyme activities of intestinal mucosa. The pigs were fed a control (C) diet based on casein or a diet in which 60% of crude protein (CP) was supplied by blue lupin (Lupinus angustifolius) (L) or pea (Pisum sativum) (P) seeds. Coefficient of total tract apparent digestibility (CTTAD) of organic matter (OM), CP and gross energy (GE) was lower in the L diet compared to the control diet. The pea-based diet presented intermediate CTTAD values of OM and GE. Coefficient of ileal apparent digestibility (CIAD) of OM and GE was lower in the legume-containing diets than with C. No significant differences were found for the CIAD of CP There was a significant interaction between diet and IRA for villus height in the jejunum and crypt width in the ileum. Duodenal and jejunal crypt width was lower in the pigs fed the legume-containing diets compared to controls. The diet influenced the specific activity of most intestinal enzymes at various sites along the small intestine. Anastomosed pigs had higher spleen and small intestine weights and lower large intestine weights as compared to intact pigs. IRA influenced intestinal villus and crypt architecture but it had no significant effect on the activities of intestinal enzymes. (Résumé d'auteur

Hypertriglyceridemic Pancreatitis: Conventional Treatment Versus Therapeutic Plasma Exchange

Introdução:A pancreatite aguda (PA) por hipertrigliceridemia (HTG) pode ser tratada com troca plasmática terapêutica (TPT), com redução rápida dos valores de triglicerídeos. Contudo, não existem estudos comparativos definitivos que comprovem o real benefício desta terapêutica. Objetivo: Comparação dos métodos de tratamento (troca plasmática terapêutica versus convencional) em doentes com PA HTG, durante um período de 12 anos (2000-2012). Métodos: Estudo retrospetivo descritivo e inferencial de 37 doentes, avaliando: sexo, idade, antecedentes pessoais, gravidade, valores de TG e evolução consoante o tratamento (“TPT” ou terapêutica convencional “C”). Resultados: Os dois grupos TPT e C mostraram-se homogéneos quanto ao sexo (p = 0,647), idade (43,5 ± 9,74 anos TPT versus 45,30 ± 9,90 anos C; p = 0.320), pancreatite prévia (40% TPT vs 40,7% C; p = 1,0) alcoolismo crónico (50% TPT vs 70,4% C; p = 0,275) e gravidade pelo score de APACHE II (p = 0,054) e Ranson às 48 horas (p = 0,258). Dos doentes 45,95% apresentava mais de um fator de risco secundário para HTG. O grupo TPT apresentou maiores valores de TG à admissão: 4850 ± 2802 mg/dL vs 1845 ± 1858 mg/dL (p = 0,001). Não se verificaram diferenças na duração do internamento 14,2 ± 6,8 dias vs 13,5 ± 9,0 dias (p = 0,56) ou na taxa de mortalidade (p = 0,47). À data de alta a redução dos TG foi superior no grupo TPT: 4433,70 ± 2896,08 mg/dL - 91,41% vs 1582,95 ± 2051,06 mg/dL – 83,92% (p = 0,002). De referir seis intercorrências minor durante a troca plasmática terapêutica. Discussão/Conclusões: Apesar do viés de seleção (estudo retrospetivo), foi constatada uma maior redução dos TG por esta técnica. As intercorrências inerentes à técnica de troca plasmática terapêutica foram de simples resolução.info:eu-repo/semantics/publishedVersio

Pleuroamniotic shunting--case report

Fetal hydrothorax refers to a collection of fluid within the fetal thorax that may be the result of chylous leak from the thoracic duct (primary hydrothorax) or generalized fluid retention associated with immune or no immune fetal hydrops (secondary hydrothorax). The authors' presents a case report occurred in 2002, of a pregnant woman that at 25 weeks' gestation that was referred to Maternidade Bissaya-Barreto-Coimbra because of a fetal hydrothorax at left, under tension and with cardiac decompensation signs. A fetal thoracocentesis was performed and the diagnosis was chylothorax. Because of a rapid reaccumulation of fluid a pleuroamniotic shunt was placed. The effusion and the cardiac decompensation signs regressed. The delivery was at 38 weeks' gestation. The newborn had been stable. Actually he has 10 months, is healthy and has a normal grow and development