Representation of the Transgender Population in Electronic Health Records: Implementation Strategy in the Public Health Care System of Buenos Aires City.

Electronic Health Records (EHR) face the challenge of collecting data about patient's gender identity in order to provide standardized and quality data to manage public policies in order to improve health disparities of the Trans population. Innovation in Health Information Technologies (HIT) develops in the midst of a cultural change process related to social representations of gender in favor of a diversity perspective. Understanding the health field as a complex adaptive system, the changes in the systems must consider multiple factors in every stage of the process. It is relevant to consider the people involved in it and the culture in which they are embedded. This article describes the implementation strategies of functionality that represents the transgender population in the EHR of the Public Health Care System of the Buenos Aires City.

Rad5 plays a major role in the cellular response to DNA damage during chromosome replication.

The RAD6/RAD18 pathway of DNA damage tolerance overcomes unrepaired lesions that block replication forks. It is subdivided into two branches: translesion DNA synthesis, which is frequently error prone, and the error-free DNA-damage-avoidance subpathway. Here, we show that Rad5(HLTF/SHPRH), which mediates the error-free branch, has a major role in the response to DNA damage caused by methyl methanesulfonate (MMS) during chromosome replication, whereas translesion synthesis polymerases make only a minor contribution. Both the ubiquitin-ligase and the ATPase/helicase activities of Rad5 are necessary for this cellular response. We show that Rad5 is required for the progression of replication forks through MMS-damaged DNA. Moreover, supporting its role during replication, this protein reaches maximum levels during S phase and forms subnuclear foci when replication occurs in the presence of DNA damage. Thus, Rad5 ensures the completion of chromosome replication under DNA-damaging conditions while minimizing the risk of mutagenesis, thereby contributing significantly to genome integrity maintenance.

Temporal regulation of the Mus81-Mms4 endonuclease ensures cell survival under conditions of DNA damage.

The structure-specific Mus81-Eme1/Mms4 endonuclease contributes importantly to DNA repair and genome integrity maintenance. Here, using budding yeast, we have studied its function and regulation during the cellular response to DNA damage and show that this endonuclease is necessary for successful chromosome replication and cell survival in the presence of DNA lesions that interfere with replication fork progression. On the contrary, Mus81-Mms4 is not required for coping with replicative stress originated by acute treatment with hydroxyurea (HU), which causes fork stalling. Despite its requirement for dealing with DNA lesions that hinder DNA replication, Mus81-Mms4 activation is not induced by DNA damage at replication forks. Full Mus81-Mms4 activity is only acquired when cells finish S-phase and the endonuclease executes its function after the bulk of genome replication is completed. This post-replicative mode of action of Mus81-Mms4 limits its nucleolytic activity during S-phase, thus avoiding the potential cleavage of DNA substrates that could cause genomic instability during DNA replication. At the same time, it constitutes an efficient fail-safe mechanism for processing DNA intermediates that cannot be resolved by other proteins and persist after bulk DNA synthesis, which guarantees the completion of DNA repair and faithful chromosome replication when the DNA is damaged.

Cell cycle-dependent regulation of the nuclease activity of Mus81-Eme1/Mms4.

The conserved heterodimeric endonuclease Mus81-Eme1/Mms4 plays an important role in the maintenance of genomic integrity in eukaryotic cells. Here, we show that budding yeast Mus81-Mms4 is strictly regulated during the mitotic cell cycle by Cdc28 (CDK)- and Cdc5 (Polo-like kinase)-dependent phosphorylation of the non-catalytic subunit Mms4. The phosphorylation of this protein occurs only after bulk DNA synthesis and before chromosome segregation, and is absolutely necessary for the function of the Mus81-Mms4 complex. Consistently, a phosphorylation-defective mms4 mutant shows highly reduced nuclease activity and increases the sensitivity of cells lacking the RecQ-helicase Sgs1 to various agents that cause DNA damage or replicative stress. The mode of regulation of Mus81-Mms4 restricts its activity to a short period of the cell cycle, thus preventing its function during chromosome replication and the negative consequences for genome stability derived from its nucleolytic action. Yet, the controlled Mus81-Mms4 activity provides a safeguard mechanism to resolve DNA intermediates that may remain after replication and require processing before mitosis.

Salmonella enterica induces joint inflammation and expression of interleukin-17 in draining lymph nodes early after onset of enterocolitis in mice.

In developing countries, one-third of reactive arthritis (ReA) cases are associated with Salmonella enterocolitis; nevertheless, there is no animal model for studying this pathology. Here we induced a self-limiting Salmonella enterica serovar Enteritidis enterocolitis in mice to analyze the onset of ReA. BALB/c mice received orally 20 µg of streptomycin 24 h before intragastric inoculation of a low dose (3 × 10(3) to 4 × 10(3) CFU) of S. Enteritidis. In response to Salmonella infection, a 30-fold increase in the expression of interleukin-17 (IL-17), measured by quantitative PCR, was observed in mesenteric lymph nodes 5 days postinfection. At this time synovitis was already evident, and concomitantly, a significant increase in joint tumor necrosis factor alpha (TNF-α) was detected by enzyme-linked immunosorbent assay (ELISA). The early development of joint lesions was accompanied by an increased expression of IL-17 in inguinal and popliteal lymph nodes. Infection with 10(7) CFU of an isogenic ΔinvG mutant bearing a defective type III secretion system of Salmonella encoded in the pathogenicity island 1 apparatus (TTSS-1) induced enterocolitis histologically similar to that triggered by the wild-type strain. Interestingly, despite the higher infective dose used, the mutant did not trigger intestinal IL-17. Moreover, no synovitis was observed in mice suffering ΔinvG enterocolitis. Neutralization of IL-17 in mice infected with S. Enteritidis prevented both synovitis and the increment of TNF-α in the joints, suggesting that IL-17 participates in the generation of Salmonella-induced ReA through the induction of TNF-α in the joints.

Thelazia callipaeda: infection in dogs: a new parasite for Spain.

BACKGROUND: Thelazia callipaeda (Spirurida, Thelaziidae), eyeworms, are known as the causative agents of thelaziosis, initially described in Asia and, later on, over the last decade, also in some European countries (e.g., Italy, France, Germany and Switzerland). In June 2010, the first case of canine thelaziosis was observed in central western Spain (La Vera region, Cáceres) and subsequent epidemiological investigation is reported in the present study. RESULTS: This study describes the first autochthonous cases of infection by T. callipaeda in dogs from central western Spain where the first case of eyeworm infection was reported.A total of 456 dogs was examined in this geographical area. Thelazia callipaeda eyeworms were observed in 182 (39.9%) animals, of which 28 showed apparent clinical signs (i.e., conjunctivitis, oedema, epiphora and petechiae). A total of 762 adult nematodes (214 males, 548 females; mean infection rate of 4.18; SD 4.74) were collected with cotton swabs or by flushing of the conjunctival sac of infected animals using physiological saline solution. Nematodes were identified as T. callipaeda according to the morphological keys and molecular analysis of sequences of a portion of the mitochondrial cytochrome c oxidase subunit 1 (cox 1) gene. The sequences were identical to those representing T. callipaeda haplotype 1, previously reported in Europe. CONCLUSIONS: The high infection rate of canine thelaziosis herein reported suggests that practitioners should include this eye infection amongst differential diagnoses of ocular diseases in dogs from this area of Spain or those moving across this area of Spain. Based on the high infection prevalence recorded, the potential public health risk to humans from this region is also discussed.

Multiple pathways cooperate to facilitate DNA replication fork progression through alkylated DNA.

Eukaryotic genomes are especially vulnerable to DNA damage during the S phase of the cell cycle, when chromosomes must be duplicated. The stability of DNA replication forks is critical to achieve faithful chromosome replication and is severely compromised when forks encounter DNA lesions. To maintain genome integrity, replication forks need to be protected by the S-phase checkpoint and DNA insults must be repaired. Different pathways help to repair or tolerate the lesions in the DNA, but their contribution to the progression of replication forks through damaged DNA is not well known. Here we show in budding yeast that, when the DNA template is damaged with the alkylating agent methyl methanesulfonate (MMS), base excision repair, homologous recombination and DNA damage tolerance pathways, together with a functional S-phase checkpoint, are essential for the efficient progression of DNA replication forks and the maintenance of cell survival. In the absence of base excision repair, replication forks stall reversibly in cells exposed to MMS. This repair reaction is necessary to eliminate the lesions that impede fork progression and has to be coordinated with recombination and damage tolerance activities to avoid fork collapse and allow forks to resume and complete chromosome replication.