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This study focussed on the clonal structure and temporal distribution of E. faecalis and E. faecium with high-level resistance to gentamicin (HLGR) and glycopeptides (GR) collected from clinical samples during 2004 to 2006 at a Portuguese Hospital. The findings were an E. faecalis-dominant and epidemic clone (PFGE-AO), the maintenance of a major epidemic E. faecium clone (PFGE-c) and a high prevalence of putative virulence genes--asa1 (aggregation substances), gelE (gelatinase), cylA (cytolysin), esp (enterococcal surface protein), and hyl (hyaluronidase)--most of them significantly associated with the major clones of both species. The E. faecalis GR isolates ST6 and the E. faecium GR isolates ST17, ST18 and ST280 belong to the clonal complexes E. faecalis-CC2 and E. faecium-CC17, which are well adapted to the nosocomial setting and are disseminated worldwide. This study highlights the need for continuous and active surveillance in this Portuguese hospital in order to follow the evolution of these epidemic and persistent clones.

Introduction: Exposure to low frequency noise (LFN) can lead to vibroacoustic disease (VAD), recognized as a systemic disease with lesions in a broad spectrum of organs. Although gastrointestinal complaints are common among individuals exposed to noise, only few studies tried to evaluate the digestive lesions. The authors performed this study in order to investigate gastric lesions in an animal model of VAD., Material and Methods: Adult Wistar rats were exposed to continuous LFN. After five weeks they were sacrificed. The stomachs were studied by light microscopy and scanning electron microscopy, and compared with stomachs of animals kept in silence., Results: Superficial erosions were present in the noise-exposed animals. Massive cell death of the gastric epithelium was observed, both by light and electron microscopy., Discussion: The erosions, reflecting cellular degeneration and death, occurred without inflammation, similar to what has been observed in other LFN-exposed organs.

We have studied the anatomical features of human aortic arches in a sample of the Portuguese population using postmortem measurements of the arches and their branches in 33 cadavers. We found that there is a significant minority of individuals (18% of the total) who did not present the usual 3-branched aortic arch; interestingly, all 2-branched arches were seen in women and all 4-branched arches were observed in men. The arterial branches could spring either from the ascending segment of the arch (61% of total) or from its horizontal segment (39% of total). Our measurements showed that the springing of the branches was associated with the narrowing of the aortic arch, so that the difference in the diameter of the aortic arch between the origin of the first and last branches could reach up to 11 millimeters. We found that the relative caliber of the arterial branches of the aortic arch depended on the position of its origin at the arch: in aortic arches with branches that were originated at the horizontal segment of the arch the first arterial branch was always the widest of the three, whereas in aortic arches with branches coming out at the ascending segment of the arch the widest arterial branch was the third one. Our data support the view that there is a wide spectrum of variations in the anatomical arrangement of the aortic arch in humans, and offer information on the prevalence of aortic arch variations in a Portuguese population.