Anaplasma ovis, the causative agent of ovine anaplasmosis in tropical and subtropical countries, is a tick-borne obligatory intraerythrocytic bacterium of sheep, goats and wild ruminants. In Tunisia, data about the molecular phylogeny and the genetic diversity of A. ovis isolates are limited to the analysis of msp4 and groEL genes. The aim of this study was to genetic characterize 40 A. ovis isolates infecting 28 goats, 10 sheep, one camel and one Rhipicephalus turanicus tick located in different geographic regions of Tunisia on the basis of 3 partial genes (gltA, groEL and msp1a). Sequence analysis revealed 6 and 17 different genotypes in the partial gltA and groEL genes, respectively. Phylogenetic analysis revealed, as expected for the groEL gene, that sequences from small ruminants and their infesting ticks clustered separately from those isolated from camels. The analysis of amino-acid Msp1a sequences identified 18 novel genotypes of Msp1a repeats from 20 A. ovis isolates. These Msp1a repeats were highly variable with 33-47 amino-acids, and the number of repeats is one for 19 isolates infecting 18 goats and one R. turanicus tick, and 4 for a single isolate found in one sheep. Phylogenetic trees based on Msp1a partial sequences revealed that the N-terminal region of Msp1a protein appear to be relatively more informative phylogeographically compared to other markers especially according to countries. The presented data give a more detailed knowledge regarding the molecular phylogeny and the genetic diversity of A. ovis isolates occurring in different animal species and their associated ticks in Tunisia.Objective To explore the perspectives of the decision makers and community members in primary health care (PHC) around the conceptualization of social participation (PS). Design An exploratory cross-sectional study with qualitative methodology. Location Health Centers of the Metropolitan Region (RM), Santiago, Chile. Participants Eight informants from the management level (group 1), 13 from execution level in PHC (group 2), 28 community members and four community agents of health (group 3). Method Interviews and discussion groups were conducted, which were recorded and transcribed. The organization and analysis of the data was done with Atlas.ti 8.1. The narratives were systematized using a thematic analysis. All the documents were codified, and we hold periodic meetings to review the existing codes, as well as discussing the inclusion of new codes. Results Group 1 refers to a more theoretical conception of PS. Group 2 expresses more concrete and operative dimensions. Group 3 indicates that PS is embodied in particular personal experiences. Groups 1 and 3 have more than one notion of social participation in health. Conclusions An institutional conception of participation prevails transversally, rooted since the 1990s. At the community level, the narratives take the form of collective practices lived around the improvement of the quality of community life mediated by the level of execution.Background The present study aimed to report a full overview of the incidence and epidemiology of foot fractures. Method Population-based epidemiological cohort study including all foot fractures over 5 years. All patient charts and radiology were manually assessed. Results A total of 4938 patients sustained 5912 foot fractures during the study period. Patients’ mean age at the time of fracture was 36.1 (21.7 SD) years. The overall incidence of foot fractures was 142.3/100,000/year. The hind foot incidence was 13.7/100,000/year, the mid foot incidence 6.5/100,000/year, and the fore foot incidence 123.9/100,000/year. The most common mode of injury was due to low energy trauma (98.7%). Conclusion This study shows an overall incidence of foot fractures to be 142.3/100,000/year. The hind foot incidence is 13.7/100,000/year, the mid foot incidence 6.5/100,000/year, and the fore foot incidence 123.9/100,000/year.Background Hallux valgus is bilateral in up to 84 % of cases. In the setting of simultaneous bilateral correction, we aim to evaluate if minimally invasive percutaneous surgery (MIS) provides any advantage compared to conventional open surgery. Methods 52 feet (26 patients) undergoing simultaneous bilateral MIS surgery were matched by severity of deformity to 52 feet (26 patients) undergoing simultaneous conventional open surgery. Patients were followed for a minimum of six months. Pre- and post-operative radiographs and clinical records were reviewed. Results There were no significant differences in pre-operative function or pain between both groups. Post-operatively, the mean hallux valgus angle (HVA) was significantly lower in the MIS group. (HVA MIS – 8.6; Open – 11.8, P = 0.013). There were no significant differences in post-operative outcome and patient satisfaction between both groups. Conclusion This study demonstrates that simultaneous bilateral MIS hallux valgus surgery can be considered for patients with bilateral symptomatic hallux valgus.Background The number of liver transplantations is increasing worldwide, and Brazil ranks in the second position. It has one of the biggest public health care systems, which is responsible for the coordination and financial funding of transplantation procedures. Meeting the demands of such a large system of transplantation has become a challenge, particularly when attempting to minimize costs of scarce and expensive resources. The aim of this study was to investigate the process of donation, the retrieval of organs, and the transplantation itself using engineering methods based on logistics analyses. Methods Three steps were used study planning, data gathering, and data analysis. Researchers surveyed professionals to acquire raw information based on their observations, experience, and knowledge. Then, a data analysis was conducted, putting together all the information gathered during the previous steps. Bias was removed, and conflicting perceptions were resolved in order to have a standard view on the transplantation process. Results Data was gathered between 2014 and 2018 and included 5502 liver donors and 2678 (48.7%) patients who received liver transplants organs. A total of 2824 organs were refused because of logistics issues (transport and handling). Interviews of health care professionals enabled the design of a process map in which 4 stakeholders were identified patient, physician, organ, and information. Conclusions The liver transplantation process is analyzed based on a supply chain methodology applying this knowledge and putting together medical and engineering sciences to promote better efficiency and outcomes for the transplantation program. Future studies should focus on the implementation of these ideas aiming to promote optimization gains in any step of the process.Objective The objective of this study was to analyze the effects of obesity on postoperative complications and patient and graft survival after kidney transplantation. Methods We retrospectively included 506 patients who received a kidney transplant in our center during eleven years. Obesity was defined by a body mass index ≥ 30 kg/m2 based on World Health Organization criteria. Using univariate and multivariate analyses, we evaluated the impact of obesity on surgical complications according to the Clavien-Dindo classification up to 30 days after surgery. The impact of obesity on graft and patient survival was assessed using a Cox proportional regression model. Results Seventy-one patients were obese (14%), and mean follow-up was 63.1 months (59.7-66.5). By multivariable analysis, obesity was associated with delayed graft function (hazard ratio [HR] = 2.60 [1.31-5.02], P = .004). Obesity was not associated with surgical complications, but cardiovascular history was (HR = 1.68 [1.09-2.99], P = .048). By Cox regression analysis, obesity was significantly associated with a higher risk of graft loss (HR = 1.55 [1.06-2.99], P = .042) but not with patient survival (HR = 1.82 [0.88-3.79], P = .106). Conclusion Obesity was associated with delayed graft function and graft loss. However, it was not associated with surgical complications. Kidney transplantation remains the best therapy for obese patients suffering from end-stage renal disease, despite shorter graft survival.Background Respiratory complications of solid organ transplant (SOT) are a diagnostic and therapeutic challenge when requiring intensive care unit (ICU) admission. We aimed at describing this challenge in a prospective cohort of SOT recipients admitted in the ICU. Methods In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome according to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1. Results Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis. Conclusions ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated.Poland’s Central Unrelated Potential Bone Marrow Donor and Cord Blood Registry (CBMDR Poltransplant) was established in 2011. Affiliated with the World Marrow Donor Association (WMDA) as PL5, the CBMDR is an internationally recognized hematopoietic stem cell donor registry with a large, high-quality donor database. Overall, Polish resources in this domain are the second largest in Europe and the fourth largest in the world, accounting for 4.8% of the WMDA Register of over 33.5 million records. In the last 10 years, the number of potential hematopoietic stem cell donors registered in Poland has increased more than 10-fold, from about 146,000 to 1,579,809 at the end of 2018. Such a growing number of donors in the CBMDR is contributing to an increase in overall numbers of donor searches in Polish databases, as well as in donations from Polish donors.In an effort to be more inclusive and embrace the international cytology community, the American Society of Cytopathology formed the International Liaison and Membership (ILM). The Worldvision Cytopathology Contest was designed by the co-chairs of this committee (Drs. Güliz A. Barkan and Esther Diana Rossi) as an opportunity of scientific exchange in the international cytology community. The idea took its inspiration from the well-known song contest, the „Eurovision Song Contest” a competition among international singers, which started as a „light entertainment” in the 1950’s to bring together a war-torn Europe. The goals of this session were to bring the worldwide cytology community together, to increase the international participation to the ASC, to attract a younger generation of pathology professionals to cytopathology, to provide education on interesting cases for the participants, and to provide training for international contestants on how to give good public presentations. The contest was successfully done at the 2019 annual meeting, and the winner was Dr.