A 28-year-old primiparous woman presented to the emergency department at 36 weeks of gestation for abdominal pain and dyspnea. She underwent uneventful sleeve gastrectomy 2 years previously. Physical examination showed abdominal diffuse tenderness with sparse abdominal metallic sounds, which were also present on the whole left chest with abolished breath sound. Results of the obstetric examination and fetus ultrasound examination were normal. An urgent low-dose computed tomography scan showed the small and large bowel in the left thoracic cavity, with contralateral mediastinal shift (Figure 1). A median laparotomy was performed, allowing delivery of a live-born neonate. Inspection of the left diaphragm showed the presence of a 3-cm diaphragmatic tear near but independent from the esophageal hiatus. Abdominal reintegration of the bowel was performed. The diaphragmatic tear was repaired with direct not absorbable sutures. Postoperative recovery of the patient and baby were uneventful. During pregnancy the growth of uterus increases intraabdominal pressure, and congenital or acquired minor resistance sites, or both, are stretched and under tension.1Paramore R.H. The intra-abdominal pressure in pregnancy.Proc R Soc Med. 1913; 6: 291-334PubMed Google Scholar In our case, we hypothesize that the diaphragmatic tear was acquired during the previous operation for gastric volume reduction and that the increasing of intraabdominal pressure during pregnancy led to its enlargement. As usual, in the presence of diaphragmatic holes, negative intrapleural pressure facilitates intrathoracic migration of abdominal organs.2Hood R.M. Traumatic diaphragmatic hernia.Ann Thorac Surg. 1971; 12: 311-324Abstract Full Text PDF PubMed Scopus (118) Google Scholar Fortunately, few dozen of cases of such a dramatic event are present in medical literature.3Reddy M. Kroushev A. Palmer K. Undiagnosed maternal diaphragmatic hernia–a management dilemma.BMC Pregnancy Childbirth. 2018; 18: 237Crossref PubMed Scopus (7) Google Scholar

Insider trading has been a topical issue in recent times. While the debate regarding insider trading usually extends to economic and ethical arguments in favour of or against the practice, in this article we attempt to ascertain the causes of the practice. The origins of insider trading are traced to the separation of ownership and control. It has been argued that insider trading is beneficial to minority shareholders and reduces the agency cost problem; this is shown to be fallacious. The authors conclude that insider trading is an agency problem and that the disciplinary mechanisms described in the literature do not inhibit the phenomena, indeed some of these mechanisms actually facilitate the occurrence of insider trading. This it is argued provides the rationale for government intervention and anti-insider trading legislation. Binnekringtransaksies het onlangs heelwat opspraak gewek. Die debat oor binnekringtransaksies bestaan hoofsaaklik uit die aanvoer van ekonomiese of etiese argumente vir of teen die praktyk. In hierdie artikel word gepoog om die oorsake van hierdie praktyk vas te stel. Die oorsprong van binnekringtransaksies word teruggevoer na die skeiding van eienaarskap en beheer. Daar is al aangevoer dat binnekringtransaksies tot die voordeel van minderheidsaandeelhouers strek, aangesien dit die agentskapsprobleem verminder, maar in hierdie artikel word aangetoon dat dit nie die geval is nie. Die skrywers kom tot die gevolgtrekking dat binnekringtransaksies 'n agentskapsprobleem is en dat die meganismes, wat volgens die literatuur hierdie praktyk aan bande behoort te le, dit in werklikheid vergemaklik. Daar word ook aangevoer dat die beweegrede vir optrede deur die staat, asook wetgewing om binnekringtransaksies te bekamp, hieruit voortspruit.