Traumatic diaphragmatic hernias: retrospective analysis

AIMS: This study classifies cases of traumatic diaphragmatic hernias (TDH) in patients admitted to the Intensive Care Unit (ICU) of the Coimbra University Hospitals (HUC) from 1990 to 2004. METHODS: Retrospective analysis of 34 cases of TDH, studying anatomical location, place and time of diagnosis, complementary tests aiding diagnosis, herniated organs, associated traumatism, morbidity and mortality. RESULTS: Twenty-eight male and six female patients with an average age of 40.5 years +/- 20.5, average SAPS score 38.8. Average length of stay was 19.1 +/- 13.6 days, all suffered from closed traumatism and were put on artificial ventilation. The left-side diaphragm was more frequently affected (94.1%) then the right. Diagnosis in 19 cases was made up in the first six hours following the diagnosis of traumatism, in four cases within 12 hours and in the remaining cases between 48 hours and 16 years after traumatism. In 13 patients the diagnosis was established intra-operatively. The stomach was typically one of the herniated organs. The most frequently associated lesions at the thoracic level were pulmonary contusion, haemothorax and pneumothorax, and at the abdominal level, haemoperitoneum and splenic lesion. The rates for complications and mortality were 55.8% and 11.7% respectively. CONCLUSIONS: TDH mainly occurs on the left side through closed thoraco-abdominal trauma following road traffic accidents. This group of patients, on average younger than others admitted to ICU, presents a longer average hospitalisation period, but has lower rates of mortality and lower SAPS severity scores. The most commonly herniated organ was the stomach and the most frequently encountered lesions were cranial-encephalic, splenic and pleural traumatisms. Pre-operative diagnosis of diaphragmatic injuries is difficult and a high index of clinical suspicion is needed after thoraco-abdominal trauma. This diagnosis should always be considered a possibility in cases of closed thoraco-abdominal traumas

Factor V Leiden and Prothrombin G20210A in Portuguese Women with Recurrent Miscarriage: Is it Worthwhile to Investigate?

OBJECTIVE: To compare the prevalence of factor V Leiden (FVL) and prothrombin (PT) G20210A mutations in Portuguese women with unexplained recurrent miscarriage (RM) and a control group of parous women. MATERIALS AND METHODS: FVL and PT G20210A analysis were carried out in 100 women with three or more consecutive miscarriages and 100 controls with no history of pregnancy losses. Secondary analysis was made regarding gestational age at miscarriage (embryonic and fetal losses). RESULTS: Overall, the prevalence of FVL and PT G20210A was similar in women with RM (5 and 3%) compared with controls (5 and 1%) OR 1.36 (CI 95% 0.45-4.08). In RM embryonic subgroup, PT G20210A was observed in 1.3% of women and FVL prevalence (2.6%) was inclusively lesser than that of controls. Both polymorphisms were more prevalent in women with fetal losses than in controls, although statistical significance was not reached due to the small size of the >10 weeks' subgroup. CONCLUSION: These data indicate that neither FVL nor PT G20210A is associated with RM prior to 10 weeks of gestation. Therefore, its screening is not indicated as an initial approach in Portuguese women with embryonic RM and negative personal thromboembolic history

Septic Arthritis Presenting as Brachial Plexus Neurophaty

Bone and joint infections are rare in the neonatal period. They often present with pseudo paralysis of the affected limb due to pain and discomfort caused by movement. The existence of a concomitant neuropathy is a rare and insuffi ciently understood phenomenon with few cases described. The authors report the case of a 7-week infant, born prematurely and with Staphylococcus aureus neonatal sepsis, who presented to the emergency room with a paretic right upper limb. Osteoarticular infection complicated with brachial plexus neuropathy was considered and MRI and electromyography the confi rmed diagnosis. There was a good outcome after antibiotic treatment and functional rehabilitation

The Word Problem for Omega-Terms over the Trotter-Weil Hierarchy

For two given $\omega$-terms $\alpha$ and $\beta$, the word problem for $\omega$-terms over a variety $\boldsymbol{\mathrm{V}}$ asks whether $\alpha=\beta$ in all monoids in $\boldsymbol{\mathrm{V}}$. We show that the word problem for $\omega$-terms over each level of the Trotter-Weil Hierarchy is decidable. More precisely, for every fixed variety in the Trotter-Weil Hierarchy, our approach yields an algorithm in nondeterministic logarithmic space (NL). In addition, we provide deterministic polynomial time algorithms which are more efficient than straightforward translations of the NL-algorithms. As an application of our results, we show that separability by the so-called corners of the Trotter-Weil Hierarchy is witnessed by $\omega$-terms (this property is also known as $\omega$-reducibility). In particular, the separation problem for the corners of the Trotter-Weil Hierarchy is decidable

Closures of regular languages for profinite topologies

The Pin-Reutenauer algorithm gives a method, that can be viewed as a descriptive procedure, to compute the closure in the free group of a regular language with respect to the Hall topology. A similar descriptive procedure is shown to hold for the pseudovariety A of aperiodic semigroups, where the closure is taken in the free aperiodic omega-semigroup. It is inherited by a subpseudovariety of a given pseudovariety if both of them enjoy the property of being full. The pseudovariety A, as well as some of its subpseudovarieties are shown to be full. The interest in such descriptions stems from the fact that, for each of the main pseudovarieties V in our examples, the closures of two regular languages are disjoint if and only if the languages can be separated by a language whose syntactic semigroup lies in V. In the cases of A and of the pseudovariety DA of semigroups in which all regular elements are idempotents, this is a new result.PESSOA French-Portuguese project Egide-Grices 11113YM, "Automata, profinite semigroups and symbolic dynamics".FCT -- Fundação para a Ciência e a Tecnologia, respectively under the projects PEst-C/MAT/UI0144/2011 and PEst-C/MAT/UI0013/2011.ANR 2010 BLAN 0202 01 FREC.AutoMathA programme of the European Science Foundation.FCT and the project PTDC/MAT/65481/2006 which was partly funded by the European Community Fund FEDER

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

Population Size, Sex and Purifying Selection: Comparative Genomics of Two Sister Taxa of the Wild Yeast Saccharomyces paradoxus

This study uses population genomic data to estimate demographic and selection parameters in two sister lineages of the wild yeast Saccharomyces paradoxus and compare their evolution. We first estimate nucleotide and recombinational diversities in each of the two lineages to infer their population size and frequency of sex and then analyze the rate of mutation accumulation since divergence from their inferred common ancestor to estimate the generation time and efficacy of selection. We find that one of the lineages has significantly higher silent nucleotide diversity and lower linkage disequilibrium, indicating a larger population with more frequent sexual generations. The same lineage also shows shorter generation time and higher efficacy of purifying selection, the latter consistent with the finding of larger population size and more frequent sex. Similar analyses are also performed on the ancestries of individual strains within lineages and we find significant differences between strains implying variation in rates of mitotic cell divisions. Our sample includes some strains originating in the Chernobyl nuclear-accident exclusion zone, which has been subjected to high levels of radiation for nearly 30 years now. We find no evidence, however, for increased rates of mutation. Finally, there is a positive correlation between rates of mutation accumulation and length of growing period, as measured by latitude of the place of origin of strains. Our study illustrates the power of genomic analyses in estimating population and life history parameters and testing predictions based on population genetic theory