From compost to culver: genome sequence and annotation of a cluster CQ1 Gordonia phage.

Phage Culver, with a siphovirus morphology, was isolated using Gordonia terrae CAG3. Culver is assigned to phage cluster CQ1 based on gene content similarity to actinobacteriophages. Notably, Culver is predicted to encode eight tRNAs, lysin A by two adjacent genes, and, unlike other CQ1 phages, two putative integrase genes.

Fecal concentration of Rhodococcus equi determined by quantitative polymerase chain reaction of rectal swab samples to differentiate foals with pneumonia from healthy foals.

BACKGROUND: Diagnostic accuracy of real-time, quantitative PCR (qPCR) assays to quantify virulent Rhodococcus equi using rectal swab samples has not been systematically evaluated. OBJECTIVE: To evaluate the accuracy of qPCR of rectal swab samples to differentiate foals with pneumonia from healthy foals of similar age from the same environment. ANIMALS: One hundred privately owned foals born in 2021 from 2 farms in New York. METHODS: An incident case-control study design was used. Rectal swabs were collected from all foals diagnosed with R. equi pneumonia at 2 horse-breeding farms (n = 47). Eligible pneumonia cases (n = 39) were matched by age to up to 2 healthy (n = 53) control foals; rectal swabs were collected from control foals on the day of diagnosis of the index case. DNA was extracted from fecal swabs and the concentration of virulent R. equi (ie, copy numbers of the virulence-associated protein A gene [vapA] per 100 ng fecal DNA) was estimated by qPCR. RESULTS: The area under the ROC curve for qPCR of fecal swabs was 83.7% (95% CI, 74.9-92.6). At a threshold of 14 883 copies of vapA per 100 ng fecal DNA, specificity of the assay was 83.0% (95% CI, 71.7-92.4) and sensitivity was 79.5% (95% CI, 66.7-92.3). CONCLUSIONS AND CLINICAL IMPORTANCE: Although fecal concentrations of virulent R. equi are significantly higher in pneumonic foals than healthy foals of similar age in the same environment, qPCR of rectal swabs as reported here lacks adequate diagnostic accuracy for clinical use.

Association of pneumonia with concentrations of virulent Rhodococcus equi in fecal swabs of foals before and after intrabronchial infection with virulent R. equi.

BACKGROUND: Intragastric administration of virulent Rhodococcus equi protects foals against subsequent experimental intrabronchial (IB) infection, but it is unknown whether R. equi naturally ingested by foals contributes to their susceptibility to pneumonia. HYPOTHESIS: Fecal concentration of virulent R. equi before IB infection with R. equi is positively associated with protection from pneumonia in foals. ANIMALS: Twenty-one university-owned foals. METHODS: Samples were collected from experimental studies. Five foals were gavaged with live, virulent R. equi (LVRE) at age 2 and 4 days; the remaining 16 foals were not gavaged with LVRE (controls). Fecal swabs were collected from foals at ages 28 days, immediately before IB infection. Foals were monitored for clinical signs of pneumonia, and fecal swabs were collected approximately 2 weeks after IB infection. Swabs were tested by quantitative PCR for concentration of virulent R. equi (ie, copy numbers of the virulence-associated protein A gene [vapA] per 100 ng fecal DNA). RESULTS: Fecal concentrations of virulent R. equi (vapA) before IB infection were significantly (P < .05) lower in control foals (25 copies/100 ng DNA [95% CI, 5 to 118 copies/100 ng DNA) that developed pneumonia (n = 8) than in healthy control foals (n = 8; 280 copies/100 ng DNA; 95% CI, 30 to 2552 copies/100 ng DNA) or those gavaged with LVRE (707 copies/100 ng DNA, 95% CI, 54 to 9207 copies/100 ng DNA). CONCLUSIONS AND CLINICAL IMPORTANCE: Greater natural ingestion of LVRE might contribute to protection against pneumonia among foals.

Carcinógenos ocupacionales relevantes en Colombia, listado actualizado (2020) / Relevant occupational carcinogens in Colombia, 2020 updated list

RESUMEN Objetivo Actualizar la lista de carcinógenos ocupacionales relevantes para el contexto colombiano. Materiales y Métodos Se elaboró un listado único para el contexto colombiano a partir del Manual de Agentes Carcinógenos de los Grupos 1 y 2A de la IARC, de interés ocupacional para Colombia (2006) y del documento CAREX-2012 del Instituto Nacional de Cancerología. Estos documentos se compararon con los listados de carcinógenos ocupacionales relevantes a nivel internacional a partir de una revisión de literatura con las palabras "occupational carcinogens", "exposure" y"neoplasm". A su vez, estas publicaciones se cotejaron con la información disponible en el Programa de monografías en línea de la Agencia Internacional para la Investigación del Cáncer (IARC), hasta la monografía número 123. Resultados Se proponen 52 carcinógenos ocupacionales relevantes, 25 químicos, cuatro físicos, cuatro biológicos, ocho mezclas y once circunstancias de exposición. Conclusiones La actualización incluyó agentes físicos: radiación ultravioleta de la soldadura y Radón-222 y sus productos en descomposición (emisores de alfa partículas); mezclas: polvo de cuero, polvo de madera y aceite de esquisto; y circunstancias de exposición: humos de soldadura y contaminación del aire exterior y material particulado en aire contaminado exterior.

ABSTRACT Objective Update of relevant occupational carcinogens list in the Colombian context. Materials and Methods A unique list was prepared for the Colombian context from the Manual of Carcinogens of Groups 1 and 2A of the IARC, of occupational interest for Colombia, 2006 and the document CAREX-2012 of the National Cancer Institute. These documents were compared with lists of internationally relevant occupational carcinogens based on a literature review with words "occupational carcinogens", "exposure", and "neoplasm". Additionally, these publications were compared with the information available in the Online Monograph Program of the International Agency for Research on Cancer-IARC, up to monograph number 123. Results 52 relevant occupational carcinogens, 25 chemical, four physical, four biological, eight mixtures and eleven exposure circumstances are proposed. Conclusions the update included physical agents: ultraviolet radiation from welding and Radon-222 and their decomposition products (emitters of alpha particles); mixtures: leather dust, wood dust and shale oil; and exposure circumstances: fumes from welding and outside air pollution and particulate matter in outside polluted air.

El evento de El Carmen de Bolívar en la vacunación contra VPH en Colombia. ¿Causa o desenlace? / The Carmen de Bolívar event in HPV vaccination in Colombia. Cause or outcome?

RESUMEN Objetivo Abrir la "caja negra" del "evento Carmen de Bolívar". Métodos Búsqueda de literatura en Medline, Lilacs y Redalyc con los términos "vacuna", "VPH", y "Colombia"; revisión de encuestas nacionales ENDS y documentos de política publicados en el sitio web del Ministerio de Salud de Colombia. Resultados Las mujeres colombianas no poseían mayores conocimientos sobre la vacuna antes de su introducción. No hubo una articulación entre la vacuna y la política de salud sexual y reproductiva; tampoco capacitaciones previas de los trabajadores de la salud de todos los niveles de atención y planes de comunicación no fueron específicos para dicha vacuna. Discusión Podría existir una nueva lista de causas para valorar "Carmen de Bolívar" más como un desenlace: la introducción de la vacuna no integrada a programas de salud sexual y reproductiva; la ausencia de fortalecimiento previo de conocimientos y competencias sobre el VPH y la vacuna en los trabajadores sanitarios, especialmente de atención primaria; la ausencia de un plan de comunicación específico previo al inicio de la vacunación guiado por los indicios de problemas de aceptabilidad en la población y de brechas de conocimiento en mujeres de la "Colombia profunda"; la implementa-ción de una estrategia operativa idéntica a vacunas para enfermedades transmisibles que no valoró las características únicas de la vacuna contra el VPH. A lo anterior se suma que el manejo de la crisis en El Carmen de Bolívar no cumplió con las recomendaciones de la OMS, hecho que, para estos casos, pudo operar como un agravante y no como causa determinante del problema actual.

ABSTRACT Objective To open the "black box" of the "Carmen de Bolívar event". Methods Search for literature in Medline, Lilacs and Redalyc with the terms "vaccine", "HPV", and "Colombia"; review of national ends surveys and policy documents published on the website of the Colombian Ministry of Health. Results Low knowledge of the vaccine by Colombian women before its introduction, no articulation to the sexual and reproductive health policy, lack of prior training of health workers at all levels of care and non-specific communication plans for HPV vaccine. Discussion There could be a new list of responsibles to assess "Carmen de Bolívar" more as an outcome. Such as the introduction of the non-integrated vaccine to sexual and reproductive health programs, the absence of prior strengthening of knowledge and skills about HPV and the vaccine in health workers, especially in primary care, the absence of a specific prior communication plan at the start of vaccination, guided by the indications of problems of acceptability in the population and knowledge gaps in women in deep Colombia, the implementation of an operational strategy identical to vaccines for communicable diseases that did not assess the unique characteristics of the vaccine against HPV. But also, the handling of the crisis in El Carmen de Bolívar that did not comply with the WHO recommendations for these cases could operate as an aggravating circumstance, and not as a determining cause of the current problem.

[The "Carmen de Bolívar event" in HPV vaccination in Colombia. Cause or outcome?] / El "evento de El Carmen de Bolívar" en la vacunación contra VPH en Colombia. ¿Causa o desenlace?

OBJECTIVE: To open the "black box" of the "Carmen de Bolívar event". METHODS: Search for literature in Medline, Lilacs and Redalyc with the terms "vaccine", "HPV", and "Colombia"; review of national ends surveys and policy documents published on the website of the Colombian Ministry of Health. RESULTS: Low knowledge of the vaccine by Colombian women before its introduction, no articulation to the sexual and reproductive health policy, lack of prior training of health workers at all levels of care and non-specific communication plans for HPV vaccine. DISCUSSION: There could be a new list of responsibles to assess "Carmen de Bolívar" more as an outcome. Such as the introduction of the non-integrated vaccine to sexual and reproductive health programs, the absence of prior strengthening of knowledge and skills about HPV and the vaccine in health workers, especially in primary care, the absence of a specific prior communication plan at the start of vaccination, guided by the indications of problems of acceptability in the population and knowledge gaps in women in deep Colombia, the implementation of an operational strategy identical to vaccines for communicable diseases that did not assess the unique characteristics of the vaccine against HPV. But also, the handling of the crisis in El Carmen de Bolívar that did not comply with the WHO recommendations for these cases could operate as an aggravating circumstance, and not as a determining cause of the current problem.

OBJETIVO: Abrir la "caja negra" del "evento Carmen de Bolívar". MÉTODOS: Búsqueda de literatura en Medline, Lilacs y Redalyc con los términos "vacuna", "VPH", y "Colombia"; revisión de encuestas nacionales ENDS y documentos de política publicados en el sitio web del Ministerio de Salud de Colombia. RESULTADOS: Las mujeres colombianas no poseían mayores conocimientos sobre la vacuna antes de su introducción. No hubo una articulación entre la vacuna y la política de salud sexual y reproductiva; tampoco capacitaciones previas de los trabajadores de la salud de todos los niveles de atención y planes de comunicación no fueron específicos para dicha vacuna. DISCUSIÓN: Podría existir una nueva lista de causas para valorar "Carmen de Bolívar" más como un desenlace: la introducción de la vacuna no integrada a programas de salud sexual y reproductiva; la ausencia de fortalecimiento previo de conocimientos y competencias sobre el VPH y la vacuna en los trabajadores sanitarios, especialmente de atención primaria; la ausencia de un plan de comunicación específico previo al inicio de la vacunación guiado por los indicios de problemas de aceptabilidad en la población y de brechas de conocimiento en mujeres de la "Colombia profunda"; la implementa-ción de una estrategia operativa idéntica a vacunas para enfermedades transmisibles que no valoró las características únicas de la vacuna contra el VPH. A lo anterior se suma que el manejo de la crisis en El Carmen de Bolívar no cumplió con las recomendaciones de la OMS, hecho que, para estos casos, pudo operar como un agravante y no como causa determinante del problema actual.

Desigualdades en la continuidad de la atención ambulatoria de población desplazada en Colombia 2012-2013 / Inequalities in the continuity of outpatient care to displaced population in Colombia, 2012 - 2013

RESUMEN Objetivo Establecer desigualdades en la continuidad de la atención ambulatoria de la población desplazada con diagnóstico de depresión. Métodos Estudio transversal a partir del registro clínico, del periodo entre el 1 de junio de 2012 y 30 de junio de 2013, sobre las personas con diagnóstico de depresión y clasificadas según desplazamiento. Se usó el odds ratio para la asociación entre tipo de población y control profesional ambulatorio, ajustado por sexo, edad, afiliación y región. Resultados Sobre 74 713 registros: 3 149 de desplazados y 71 564 no desplazados; se encontró 24 % más atención ambulatoria en los no desplazados (OR: 1,24 p<0.001; IC 1,10-1,39), la ventaja fue mayor al ajustar por afiliación al sistema. En el grupo de desplazados se encontró mayor atención ambulatoria en los hombres frente a las mujeres (OR: 1,40 p<0.001 IC: 1,08-1,83). Fue mayor también la desventaja para aquellas, con respecto a mujeres no desplazadas (OR: 1,26 p<0.001 IC: 1,10-1,44). Si bien estos resultados se obtuvieron en la atención de depresión leve y moderada, no en grave, la primera fue diagnosticada en el 92 % de las personas. Discusión El registro de prestaciones demostró desigualdades en la continuidad de la atención ambulatoria y aunque su calidad ha mejorado, su cobertura todavía es incompleta. En el primer año con plan único del Sistema de Salud, parece que las coberturas no lograron por sí solas evitar diferencias en la atención de la población desplazada. Se necesita mejorar el registro y la interoperabilidad, para políticas de salud con enfoque de equidad.(AU)

ABSTRACT Objective To establish inequalities in the continuity of outpatient care to displaced population diagnosed with depression. Methods A cross-sectional study, based on clinical records, was performed during the period between June 1, 2012 and June 30, 2013, on population diagnosed with depression and reduced to displaced population. The odds ratio was used to associate the type of population with the outpatient care control by professionals, adjusted by sex, age, affiliation and region. Results The following information was obtained from 74 713 records: 3 149 related to displaced population and 71 564 to non-displaced population; non-displaced population had 24 % more ambulatory care (OR: 1.24 p<0.001; CI 1.10 to 1.39), and the advantage was greater when adjusting the information to data, based on affiliation to the health system. In the displaced population group, men had greater rates of outpatient care compared to women (OR:1.40 p<0.001 CI: 1.08 to 1.83). The disadvantage was also high for non-displaced women (OR:1.26 p<0.001 CI: 1.10 to 1.44). Although these results were obtained for outpatient care in mild and moderate depressive patients, severe depression was excluded; the first type of depression was diagnosed in 92 % of people. Discussion The performance record showed inequalities in the continuity of outpatient care and, despite the improvement of quality, its coverage is still incomplete. During the first year of the unified plan for the Health System, apparently, the coverage has not achieved to avoid by itself differences in care of displaced population. Improvement of records and interoperability is necessary for designing health policies with an equitable approach.(AU)

[Inequalities in the continuity of outpatient care to displaced population in Colombia, 2012 - 2013]. / Desigualdades en la continuidad de la atención ambulatoria de población desplazada en Colombia 2012-2013.

OBJECTIVE: To establish inequalities in the continuity of outpatient care to displaced population diagnosed with depression. METHODS: A cross-sectional study, based on clinical records, was performed during the period between June 1, 2012 and June 30, 2013, on population diagnosed with depression and reduced to displaced population. The odds ratio was used to associate the type of population with the outpatient care control by professionals, adjusted by sex, age, affiliation and region. RESULTS: The following information was obtained from 74 713 records: 3 149 related to displaced population and 71 564 to non-displaced population; non-displaced population had 24 % more ambulatory care (OR: 1.24 p<0.001; CI 1.10 to 1.39), and the advantage was greater when adjusting the information to data, based on affiliation to the health system. In the displaced population group, men had greater rates of outpatient care compared to women (OR:1.40 p<0.001 CI: 1.08 to 1.83). The disadvantage was also high for non-displaced women (OR:1.26 p<0.001 CI: 1.10 to 1.44). Although these results were obtained for outpatient care in mild and moderate depressive patients, severe depression was excluded; the first type of depression was diagnosed in 92 % of people. DISCUSSION: The performance record showed inequalities in the continuity of outpatient care and, despite the improvement of quality, its coverage is still incomplete. During the first year of the unified plan for the Health System, apparently, the coverage has not achieved to avoid by itself differences in care of displaced population. Improvement of records and interoperability is necessary for designing health policies with an equitable approach.

Large intramyometrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report.

A case of an adenomyotic cyst in a 46-year-old woman was examined by means of transvaginal ultrasound, hysteroscopy and microscopy. The transvaginal ultrasound showed an anechoic area. Hysteroscopy revealed a cystic mass of the posterior wall and by means of a bipolar loop resectoscope the mass was removed. Histological examination of the lesion showed typical characteristics of an adenomyotic cyst. These results were consistent with those of previous reports and suggest that transvaginal ultrasound together with hysteroscopy is specific to diagnose and treat this kind of adenomyotic lesion.

Massive myxoid leiomyosarcoma of the uterus.

Uterine myxoid leiomyosarcoma is a very rare and aggressive variant of uterine sarcoma, of which only 26 cases have been described in the literature published in English. A 59-year-old woman, who had been menopausal for 5 years and had a huge abdominal mass underwent laparotomy; histopathology of the bulky tumor revealed the particular characteristics of a myxoid leiomyosarcoma. Immunohistochemically, Ki-67 contributed toward indicating a malignancy, whereas p53 and progesterone and estrogen receptors were negative. The level of serum Ca125 was high at diagnosis, within normal limits after the fifth cycle of chemotherapy, and subsequently increased again at recurrence. Sixteen months after surgery, the patient died of respiratory failure. Immunohistochemistry and Ca125 levels can aid the diagnosis, management, and prognosis of uterine myxoid leiomyosarcoma.

Angiomyofibroblastoma of the vulva: report of a case.

A case of solitary angiomyofibroblastoma of the vulva in a 16-year-old woman was examined by histology and immunohistochemistry. Microscopic examination of the tumor revealed typical features of a mesenchymal neoplasm, composed of bundle spindle cells with low cellular density, rich in collagen fibers and thin-walled blood vessels. Immunohistochemistry revealed immunoreactivity for progesterone receptor, CD34, desmin and vimentin, tumor cells expressing positivity, but not for estrogen receptors. The stains for the muscle-specific actin and S-100 were negative. These results were mostly consistent with those of previous reports and suggest that the tumors cells were derived from primitive mesenchymal cells which occur normally in this region and show the potential for diverse lines of myoid differentiation.

Retinoids in breast cancer prevention and treatment. A review of the literature.

During the last three decades, research focused on cancer treatment has led to the development of many cytotoxic agents. Despite the fact that these efforts have significantly improved the prognosis of certain malignancies such as some lymphomas, leukemias and testicular carcinomas, other tumors such as ovarian, lung and metastatic breast cancer are still associated with a poor prognosis. An innovative approach has recently emerged, thanks to a better understanding of tumor cell biology and many efforts are aimed at finding compounds capable of restoring a more differentiated phenotype to tumor cells, thereby reducing the tumor's aggressiveness and ultimately reverting it to its normal counterpart [1, 2]. Retinoids are the prototype of this new therapeutical approach called "differentiation therapy".

Fixaçäo percutânea das fraturas supracondilianas do úmero na criança / Percutaneous fixation of supracondylar fractures of the humerus in children

Trinta e um casos de fraturas supracondilianas do úmero em crianças foram revisado. A técnica utilizada para o tratamento foi a fixaçäo percutânea. Os casos forama valiados clinicamente através do âangulo de carga e da mobilidade articular. Para a avaliaçâo radiológica, foram utilizados os ângulos de Baumann e metáfise-diafisário. O follow-up médio foi o de quatro anos e seis meses. Foram obtidos resultados clínicos satisfatórios em 28 casos e insatisfatórios em três casos. Em cinco casos o ângulo de carga foi negativo (cúbito varo)

Luxaçäo congênita do quadril após início da marcha / Congenital dislocation of the hip after beginning of gait

Foram analisados 28 casos em 19 pacientes portadores de luxaçäo congênita do quadril, cujo diagnóstico foi feito em fase tardia. Todos os casos foram tratados através da reduçäo aberta. Em 20 casos a reduçäo aberta foi precedia de traçäo. Nas crianças com mais de três anos e meio de idade, em substituiçäo à traçäo, foi utilizado o encurtamento do fêmur concomitante à reduçäo aberta. A idade média, por ocasiäo da reduçäo aberta, foi de três anos. O follow-up médio foi de seis anos e um mês. Os pacientes foram avaliados clinicamente utilizando-se a classificaçäo de Severin modificada por Gibson & Benson. Quinze pacientes foram classificados como excelentes (grupo 1) e quatro como bons (grupo 2). Para a avaliaçäo radiológica, utilizou-se a classificaçäo como grau I, 10 como grau II e um como grau III. A mobilidade articular foi avaliada através do sistema de pontos de Ferguson & Howorth. Dezenove casos foram considerados como excelentes e nove como bons. Em um caso ocorreu necrose avascular

[Sulprostone in the prevention and therapy of hemorrhage due to postpartal uterine atony]. / Il sulprostone nella prevenzione e terapia della emorragia da atonia uterina post-partum.

Sulprostone (Nalador-Schering) was used on 25 cases of bleeding caused by post-partum atonia that did not respond to conventional uterotonic treatment. The good results obtained led to the use of the drug whenever it was necessary to prevent haemorrhage independent of the risk factors that might cause its onset.

Is tubal rupture a discriminating factor in the surgical conservative treatment of ectopic pregnancy?

217 women have been submitted to a surgical intervention for ectopic pregnancy in the years 83 - 84 - 85 in five hospitals in Piedmont. The rupture has been observed in 147 cases (67%). The percentage of women who presented a rupture was higher among those who underwent annexiectomy (75%), average among those who underwent salpingectomy (69%) and lower in case of conservative intervention (52%). Owing to these rather high percentages, we cannot state that the rupture is a discriminating factor as far as it concerns the choice of intervention, even if a fairly more conservative orientation is evident in case of unruptured tube.

Ectopic pregnancy: which treatment? Analysis of 217 cases.

The Authors describe the various types of treatment performed on 217 cases of ectopic pregnancy examined, which took place in the years 1983 - 84 - 85 in five among the main Hospital in Piedmont. 136 salpingectomies (62%), 41 annexiectomies (18%), 40 conservative interventions (20%) were performed. In most cases the destructive intervention was performed in the presence of a tubal rupture; no meaningful relations between the location and the type of surgical treatment have been found in the ectopic pregnancy. Conservative interventions have been more frequent on young women (under 35: 97%) and desiring children either because nullipara (65%) or because uniparous (27%). The highest number of conservative interventions was performed in the largest of the five Hospitals examined (23 cases: 57%). There is therefore a remarkable relation between diagnostic and therapeutic means and the possibility of performing the surgery most appropriate to the specific requirements of each case.

Comparative evaluation of ectopic pregnancy surgical treatment between a specialized hospital and a general hospital.

The surgical approaches followed in cases of ectopic pregnancy by the operators in two centres in Piedmont, one specialized in ostetrics and gynecology, the other a general county hospital are taken into consideration and compared. 131 cases have been registered in Turin and 30 in Biella. The salpingectomy has been performed on most cases in both centres with 56.5% and 66% respectively in the specialized Hospital and in the General one. The annexiectomy has been chosen for 25%. The intervention aiming at preserving the tube has been chosen for 17.5% in Turin and 34% in Biella. The most discriminating factor in choosing the type of intervention is mainly based on the patient's amnestic history, and therefore on her age, parity, any preceeding tube intervention and also on her desire for children.

[A case of primary adenocarcinoma of the cervix of probable origin from an area of endometriosis]. / Su di un caso di adenocarcinoma primitivo della portio a probabile insorgenza su area di endometriosi.

A case of primary adenocarcinoma of the cervix of probable endometrial origin is described in a 37 year-old woman.

[Method of carrying out a vaginal delivery after cesarean section]. / Modalità di espletamento del parto vaginale dopo taglio cesareo.

51 cases of successful vaginal childbirth after caesarean section are reported. An assessment of the various methods used for vaginal parturition showed the spontaneous eutocic type to be the most frequent (66,6%). The incidence of instrumental parturition was only 33,33%. Foetal condition was good, both in terms of weight and the A.P.G.A.R. index: no maternal complications were reported.