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Comparative genomics of the monophasic variant of Salmonella Typhimurium: analysis of Colombian genomes and their relationship with international lineages.

The monophasic variant of Salmonella enterica serovar Typhimurium (STVM) represents a growing threat to global public health owing to its wide dissemination, capacity to adapt to multiple hosts, and antimicrobial resistance. In this study, 98 STVM isolates recovered in Colombia (57 from humans and 41 from pig farms and abattoirs) were genomically characterized between 2015 and 2022 and compared with 102 representative genomes of international lineages by whole-genome sequencing (WGS) and phylogenomic analysis. Phylogenomic analysis revealed the existence of two well-defined endemic lineages in Colombia (Clusters 1 and 2), arising from independent introduction events and subsequent local stabilization. Both lineages comprise isolates of human and swine origin without clear phylogenetic separation by host species, suggesting active zoonotic cocirculation and closely integrated interspecies transmission dynamics. Marked differences were observed in the accessory genome, including the differential presence of prophages (e.g., Gifsy-2, Fels-2, SW9), virulence plasmids, and resistance profiles. The Colombian lineages exhibited a high frequency of the pSTV plasmid (85%, n = 84/98) and a substantial burden of resistance determinants to quinolones (such as qnrB19, 74.5%; gyrA S83F mutation, 19.4%), phenicols (floR), tetracyclines (tetA, tetB), β-lactams (blaTEM-1B), and heavy metals. In contrast, the Colombian genomes clustered with the European ST34 lineage lacked pSTV but retained resistance and heavy metal operons. These findings demonstrate that international and endemic lineages coexist in Colombia with independent evolutionary trajectories, underscoring the need to strengthen genomic surveillance under the "One Health" approach to anticipate emerging threats and develop integrated control strategies.IMPORTANCEThe monophasic variant of Salmonella Typhimurium (STVM) has emerged as a predominant serovar in both humans and swine internationally. In Colombia, a fundamental question driving this study was whether local isolates belonged to international lineages or represented endemic strains. This study provides the first comprehensive genomic characterization demonstrating that two Colombian endemic lineages circulate simultaneously between humans and pigs without phylogenetic separation by host species, confirming active zoonotic transmission. The results demonstrate the coexistence of both lineages, each with distinctive repertoires of mobile genetic elements and specific antimicrobial resistance profiles. Understanding these transmission dynamics and evolutionary patterns is crucial for public health, as it demonstrates how zoonotic pathogens can establish locally adapted lineages with distinct resistance patterns. The genomic evidence of sustained interspecies circulation highlights the critical need for integrated surveillance strategies under the "One Health" framework. This will enable anticipating emerging threats, tracing transmission routes, and developing targeted interventions in food production systems.

One Health↗

Gene-for-gene complementarity in plant-pathogen interactions.

The cloning of avirulence genes has greatly aided our understanding of plant-pathogen specificity. It has proven that the gene-for-gene relationship first noted by Flor is correct--single avirulence gene encoding single protein products indeed are the genetic elements that interact with plant disease resistance genes. Furthermore, firm genetic evidence has provided insight into how two cloned avirulence genes (the TMV coat gene and avrD) cause the HR. The differences in structure of pathogen elicitors also indicates that plants have evolved diverse recognitional mechanisms to detect pathogens. It is appealing to speculate, therefore, that elicitors represent the plant equivalent of antigens in vertebrates. Another consequence of these results has been the establishment of firm genetic and biochemical evidence supporting the elicitor-receptor model for recognition of incompatible pathogen races by plants. In both TMV and bacterial pathogens, we are also beginning to understand how avirulence genes are altered to confound plant recognition of the pathogen. The next few years should yield additional information on avirulence gene structure as well as the important questions of their function in the pathogen and the molecular mechanisms whereby plant recognition occurs. The marked successes in cloning avirulence genes underscore only more forcefully the pressing need to clone and characterize plant disease resistance genes. Certainly an understanding of these genes is required to further our basic knowledge of active defense in plants and to permit their manipulation for improved control of plant diseases in practical agriculture.

Cloning, Molecular↗

Research on the Rust Fungi During the Twentieth Century.

▪ Abstract Interest in the rust fungi derives from their success as plant pathogens. For example, the epidemic on coffee had serious economic and social impacts on diverse cultures. During the century, research on the rust germling shifted from a study of germling development, including a search for the signals that induce differentiation, to an examination of the genes expressed during host colonization. Research on host resistance was most influenced by Stakman, who studied the genetics and epidemiology of rust disease. His innovations enabled Flor to propose the gene-for-gene hypothesis, a concept that stimulated development of resistant crops, and led to research that gradually shifted during the century to an examination of the molecular basis of rust genetics.

appressoria↗

Advances in Plant Health Management in the Twentieth Century.

▪ Abstract Plant health management is the science and practice of understanding and overcoming the succession of biotic and abiotic factors that limit plants from achieving their full genetic potential as crops, ornamentals, timber trees, or other uses. Although practiced as long as agriculture itself, as a science-based concept, plant heath management is even younger than integrated pest management (IPM), and includes and builds upon but is not a replacement for IPM. Probably the greatest collection of success stories for plant health management is the number of diseases managed by cleaning up the planting material. The record for root health management is more mixed, with the loss or phase-out of soil fumigants, and practices such as crop rotation and clean tillage being replaced with more intensive cropping and less or no tillage. Perhaps the greatest scientific and technical advances for plant health management have come from the work aimed at management of the pathogens, pests, and other hazards that arrive by air. Flor's work on flax rust, which produced the gene-for-gene model, is possibly the most significant contribution of plant pathology to the life sciences in the twentieth century. Research aimed at the management of foliar pathogens is also the basis for modern theory on epidemiology, population biology, aerobiology, and disease prediction and decision-support systems. Even IPM arose mainly in response to the need to protect crops from pests that arrive by air. If the definition of biological control includes the plant induced or genetically modified to defend itself, as it should, then biological control has been the most significant approach to plant health management during the twentieth century and promises through modern biotechnology to be even more significant in the twenty-first century. Rather than "reducing losses," the advances are discussed here within the simple framework of achieving the attainable yield by increasing the actual and/or affordable and hence the average yield. Each of these four benchmark yields, as well as the absolute yield for crops, and their significance to the goals and achievements of plant health management are defined. Plant health management is a moving target, which I discuss metaphorically like an American football game, where one team is science and technology and the other is nature, where the S & T team is only beginning to know nature's rules while playing itself with the three sets of rules written to, respectively, satisfy the laws of economics, protect the environment, and gain social acceptance.

Journal Article↗

Local regulation of collateral ventilation by oxygen and carbon dioxide.

The effects of changes in CO2 and O2 on the mechanics of collateral ventilation were studied in anesthetized paralyzed dogs. A doublelumen catheter was wedged into a peripheral airway obstructing a segment of lung distal to the catheter. Through one lumen of the catheter, air, 5% CO2 in air, 10% CO2 in air, 5% O2 in N2, or 5% CO2 in N2 was infused at a constant flow (V). Pressure (Ps) was monitored through the other lumen. At functional residual capacity the resistance to collateral flor Rcoll = Ps/V. When V was interrrupted , the time for Ps to fall 63% was defined as the time constant for collateral ventilation, Tcoll. The effective compliance (Cs') = Tcoll/Rcoll. When air was replaced by 5% CO2, Rcoll fell 46.3% (+/- SE 2.8) and Tcoll fell 41.5% (+/- SE 3.0). When the CO2 concentration was increased from 5% to 10%, Rcoll fell an additional 9.2% (+/- SE 2.2) and Tcoll fell an additional 5.1% (+/- SE 4.4). When air was replaced by 5% O2 in N2, Rcoll rose 36.6% (+/- SE 6.0) and Tcoll rose 13.6% (+/- SE 10.5). No significant changes in Cs' were noted. We conclude that varying concentrations of CO2 and O2 provide potent mechanisms for the control of collateral ventillation which may be of importance in the regulation of ventillation perfusion relationships at the local level.

Airway Resistance↗

Molecular characterization of drug-resistance genes and dynamics of multidrug-resistant Salmonella spp. in waterfowl: a pre- and post-antibiotic ban surveillance in Guangdong, China from 2013 to 2023.

BACKGROUND: Multidrug-Resistant Organism (MDRO) refers to bacteria that are Resistant to three or more types of antibiotics in clinical use. The global health threat posed by multidrug-resistant (MDR) bacterial pathogens and their cross-species transmission necessitates rigorous Surveillance. This urgency is amplified in China where antibiotic growth promoters were widely used in animal husbandry until the 2020 implementation of Announcement No. 194 launched by Ministry of Agriculture and Rural Affairs (Announcement 194), banning non-therapeutic antibiotics in feed. This study conducted a decade long investigation on the correlation between antimicrobial resistance (AMR) phenotypes and genetic determinants in 314 Salmonella isolates collected from waterfowl across Guangdong Province, China, utilizing disk diffusion (Kirby-Bauer method) and PCR-based detection of antibiotic resistance genes (ARGs). The study period covered the antibiotic policy transition in China, specifically encompassing the pre-ban (2013-2019) and post-ban (2020-2023) phases of the nationwide prohibition on growth-promoting antimicrobials in animal feed. METHODS: Antimicrobial Susceptibility profiles against 16 agents were determined via Kirby-Bauer testing, while PCR amplification targeted 20 ARGs. Statistical analyses evaluated phenotype-genotype correlations using Pearson`s chi-square test. RESULTS: Surveillance revealed escalating resistance rates annually. Highest resistance prevalence was observed against &#x3b2;-lactams and amphenicols (92.25%), whereas amikacin exhibited the lowest resistance rate (9.55%). MDR prevalence reached 87.23%, with the AMP-CAZ-GEN-FFC-TET resistance profile predominating (51.6% of isolates). Genetic analysis identified 3 to 16 ARGs per isolate was harboring, with blaTEM demonstrating the highest detection frequency (90.76%). Significant phenotype-genotype correlations (p&#x2009;<&#x2009;0.05) were observed for 13 genes: blaCTX-M, blaTEM, blaOXA, aacC2, aph(3')-I, aac(3)-IV, aadA1, qnrS, qnrA, clmA, floR, sulII, tetA. Notably, significant declines in resistance to aminoglycosides (e.g., gentamicin from 71.7 to 3.5%) and florfenicol (from 81.1 to 9.6%) were observed after China's 2019 antibiotic ban policy (p&#x2009;<&#x2009;0.001), underscoring the impact of targeted antimicrobial stewardship in avian husbandry. CONCLUSIONS: Analysis of 314 waterfowl Salmonella strains revealed severe multidrug resistance (MDR) and diverse resistance genes (DRGs), with 13 DRGs linked to resistance. China's antibiotic ban reduced targeted resistance, but MDR persists alarmingly via acquired DRGs and adaptation. Continued enforcement may lower aminoglycoside/phenicol resistance, but &#x3b2;-lactam resistance will likely endure, worsened by transcontinental blaCTX-M spread. Critically, plasmid co-selection threatens to amplify MDR, demanding genomic surveillance. Mitigation requires boosting policy compliance, developing non-antibiotic therapies, mapping mutations, establishing cross-species barriers, and prioritizing One Health interventions to block resistance spread.

China↗

Characterization of the oral microbiota and antimicrobial resistance genes in shelter dogs in Japan.

Companion animals can serve as reservoirs of antimicrobial resistance genes and zoonotic microorganisms, yet information on shelter dogs remains limited. This study characterized the oral microbiota and screened for antimicrobial resistance genes in shelter dogs in Japan. Oral swabs were collected from 81 dogs, microbial genomic DNA was extracted, bacterial communities were profiled by 16S rRNA gene amplicon sequencing, and antimicrobial resistance genes were screened by PCR. We detected genes conferring resistance to several antimicrobial classes, including &#x3b2;-lactams, tetracyclines, macrolide-lincosamide-streptogramin B, phenicols, and sulfonamides. cfxA was detected in all 81 samples, followed by sul1 (66/81), tet(M) and sul2 (65/81), floR (39/81), mecA (17/81), and erm(B) (15/81). We identified potentially pathogenic genera including Capnocytophaga, Pasteurella, Fusobacterium, Campylobacter and Corynebacterium. Microbiome analysis revealed that at the phylum level, Pseudomonadota and Bacteroidota were the most dominant, while Porphyromonas, Frederiksenia and Moraxella were the most prevalent genera. Our findings highlight that (i) the oral microbiota of shelter dogs broadly resembles that reported in companion dogs and (ii) shelter dogs represent an overlooked reservoir of clinically relevant antimicrobial resistance genes and potentially zoonotic bacteria. Therefore, it is necessary to include shelter animals in antimicrobial resistance surveillance programs to capture any potential gaps in the antimicrobial resistance prevalence in companion animals and prevent dissemination of resistant bacteria to humans following adoption of shelter dogs and cats.

antimicrobial resistance gene↗

Reappearance of Aedes aegypti (Diptera: Culicidae) in Lima, Peru.

We report here the reappearance of Aedes aegypti in the Rimac district, and summarize the history of this mosquito species in Peru since its first detection in 1852. On March 17 2000 were found Ae. aegypti and Culex quinquefasciatus in Mariscal Castilla town, Flor de Amancaes, San Juan de Amancaes, El Altillo and Santa Rosa in the Rimac district, Lima Province.

Aedes↗

Designing a behavioral program for a barrio in Tegucigalpa, Honduras.

Health in Housing initiated a behavioral program of education and skills training for children and adults in a community of 30,000 persons living in substandard conditions in Tegucigalpa, Honduras. To measure achievement in the long-range project, 21 families of Flor del Campo participated in a preliminary three-part survey of their (a) health, (b) housing and the environment, and (c) family history. Doctors, designers, and educators worked with Honduran personnel in the first survey. Following functional analyses of the home and surrounding environment and the physical status of the individuals living there, procedures provide the family with treatment and training for home and environment improvement. Graphic, verbal, and numerical data, incorporated into a master computerized system, record events of each family member: training programs experienced, health care delivery courses taken, medical treatments, growth of children, literacy changes, educational courses completed, kinds and amounts of foods eaten, household and building materials purchased. Ongoing functional analysis and a long-range evaluation are made of the progress of each participating individual in a family. Teams revisit each house to observe and record any changes in the physical and environmental facility and the health and life-styles, and to report any indications of new health problems or recurrences.

Journal Article↗

Effect of vaginal misoprostol application for cervical softening in pregnancy interruption before ten weeks of gestation.

OBJECTIVE: To determine the effect of vaginal misoprostol application for cervical dilatation and to determine the time taken for pregnancy interruption. METHODS: 200 micrograms misoprostol and gyno-flor vaginal tablet, employed to create acidic milieu, were applied into the posterior fornix of 40 women with gestational age of 5 to 10 weeks. Placebo was applied vaginally to 20 women who made up the control group. All cases were examined 5 hours later. The cervical dilatation, presence of fetoplacental material in the vagina, extrauterine cervical bleeding and the time necessary for dilatation and suction curettage were investigated. RESULTS: In 33 (82.5%) of the cases cervical bleeding, in 21 (52.5%) of the cases fetoplacental material on the cervix and/or in the vagina were detected in women of misoprostol group, while neither cervical bleeding nor fetoplacental material on the cervix and/or in the vagina was detected in the placebo group. In the misoprostol group the time taken for the operation was significantly (p < 0.005) shorter than that of the control group. CONCLUSION: Vaginal application of misoprostol shortens the time needed for the termination of the gestation by its facilitating effect on cervical dilatation.

Abortion, Induced↗

Reproducibility of regional cerebral blood flow measurements in acute severe head injury.

In order to evaluate the reproducibility of regional cerebral blood flow (rCBF) measurements in pathological brain tissue, serial measurements were carried out in 13 determinations performed in patients who were comatose after severe head injuries within the first 2 weeks after the head trauma. The xenon-133 intra-arterial method was used for the flow measurements, and the flow was studied separately in 16 areas of the brain, producing 197 regional double determinations. The patients were maintained in a steady state during and between the measurements, and only differences of less than 2 mm Hg in the arterial CO2 pressure and less than 5 mm Hg in the perfusion pressure were tolerated. The reproducibility was found to be reasonably good as regards initial slope-flow indices and height/area flow indices and height/area flow values, whereas that of the compartmentally calculated flow parameters was poorer. On dividing the series into severely and moderately pathological areas, it could be shown that the reproducibility of the flor values in the moderately pathological brain areas was acceptable and similar to the results reported by others, whereas the reproducibility in the most severely pathological areas of the brain was rather poor, as regards the flow in the fast compartments. The correlation between the various flow parameters was found to be fairly good.

Brain Injuries↗

FMT alleviates multidrug-resistant Salmonella enterica-induced diarrhea and is associated with loss of IncHI2A-associated resistance determinants in mice.

INTRODUCTION: Multidrug-resistant (MDR) Salmonella enterica (S. enterica) poses a serious threat to animal and public health because of increasingly limited treatment options. Fecal microbiota transplantation (FMT) is a potential microbiota-based intervention; however, its effects on MDR Salmonella infection and pathogen-associated antibiotic resistance gene (ARG) dynamics remain unclear. METHODS: A murine diarrhea model was established using the clinical MDR S. enterica isolate P174, and infected mice were treated with FMT. Clinical symptoms, intestinal pathology, transcriptional inflammatory responses, gut microbiota composition, and ARG profiles of recovered Salmonella isolates were evaluated. Whole-genome sequencing was used to characterize resistance determinants, and the stability of ARGs and IncHI2A backbone markers was further assessed during 19 in vitro passages. RESULTS: FMT reduced diarrhea, promoted body weight recovery, and alleviated intestinal tissue injury and inflammatory cell infiltration. Colonic expression of Tnf, Il1b, and Il6 decreased, whereas Il10 expression increased. FMT was also associated with partial recovery of gut microbial diversity, increased relative abundances of Lactobacillus, Bifidobacterium, and other commensal anaerobic taxa, and reduced Salmonella abundance. Whole-genome sequencing showed that bla OXA-1, floR, oqxA, and oqxB were co-localized on an IncHI2A-associated plasmid sequence. Loss of these resistance determinants increased over time in isolates recovered from FMT-treated mice, whereas no loss of the four ARGs or the IncHI2A backbone markers repB and parB was detected during 19 in vitro passages. Among isolates showing simultaneous loss of all four ARGs, nearly all also lacked detectable repB and parB, whereas isolates with partial ARG loss retained both markers. These patterns were consistent with both backbone-associated loss and resistance-region deletion or rearrangement. Most ARG-loss isolates showed reduced antimicrobial resistance. DISCUSSION: FMT alleviated MDR S. enterica-induced intestinal disease and was associated with partial recovery of gut microbiota characteristics and increased instability and loss of IncHI2A-associated resistance determinants in vivo. These findings suggest a potential association between intestinal microbial ecological changes and altered maintenance patterns of resistance-associated genetic elements in MDR S. enterica.

Salmonella enterica↗

[Genomic characteristics of multi-drug resistant of non-O1/non-O139 Vibrio cholerae ST1565 from sepsis cases].

To analyze the genomic characteristics of multi-drug resistant of non-O1/non-O139 Vibrio cholerae ST1565 from sepsis cases. An 88 years old male patient admitted to Huashan Hospital in Shanghai on July 2, 2025, who was retrospectively analyzed. The clinical diagnosis was severe bacterial enteritis and secondary NOVC sepsis. Blood culture confirmed the presence of non-O1/non-O139 group Vibrio cholerae. The strain was a multidrug-resistant isolated of ST1565 as determined by whole-genome sequencing. The ResFinder database predicted 11 resistance genes for 6 classes of antibiotics: qnrVC5, sul2, floR, tet(59), aph(6)-Id, aph(3'')-Ib, dfrA15, dfrA31, almE, almF, and almG. Except for the quinolone qnrVC5, which was not expressed, the other resistance genes were consistent matched the phenotypic results. Additionally, 8 insertion sequences were identified: ISVch1, ISVvu4, ISVch6, ISVvu8, ISVpa3, ISVpa4, ISVsa3, and ISShfr9. Important virulence factors included 3 secreted protein toxin genes: Vibrio cholerae hemolysin, repeat toxin, and Vibrio parahaemolyticus thermostable direct hemolysin. The patient was cured after sequential treatment with meropenem, levofloxacin, and doxycycline. NOVC/ST1565 is a newly identified sequence type in China, which exhibits multidrug-resistant and hypervirulent phenotypes.

Drug Resistance, Multiple, Bacterial↗

Dissemination of Salmonella enterica serotype agona and multidrug-resistant Salmonella enterica serotype typhimurium in Cuba.

The molecular epidemiology, antimicrobial susceptibility, and mechanisms of resistance of 34 Salmonella spp. strains causing acute gastroenteritis, isolated from different provinces in Cuba, were determined. Sixty-four percent of the strains showed multiresistance. Salmonella typhimurium was the most frequent with 15 strains (44%), 13 of which belonged to phagotype 104 and presented similar genetic profiles of pulsed field gel electrophoresis. High levels of resistance to tetracycline (53%), spectinomycin (50%), ampicillin (44%), and chloramphenicol (41%) were found. Resistance to tetracycline was associated with the tet G and tet A genes. Resistance to ampicillin was caused by the presence of beta-lactamases, mainly the CARB type. The floR gene was the main mechanism of resistance to chloramphenicol. Our results showed an antimicrobial susceptible clone of Salmonella enterica serotype Agona in two separate regions. This is the first report of the widespread dissemination of a multiresistant clone of S. enterica serotype Typhimurium definitive phage type 104 in Cuba.

Anti-Bacterial Agents↗

[CT anatomy of the sella turcica and its environment].

If MRI is not considered because of its limited capacity, computed tomography has become an exclusive diagnostic method in recent years in our country for the radiologic visualization of the sella turcica and its vicinity. Interpretation of the findings of this method lies on the knowledge of normal anatomical situations and variations. In direct coronal sections the hypothalamus, pituitary gland, suprachiasmatic cystern, optic chiasm, infundibular recess, sellar flor and the nerves transversing the cavernous sinus are visualised. The axial sections are more suitable for the visualization of the posterior lobe of pituitary gland and dorsum sellae. The Meckel's cavity, infundibulum and the blood vessels around the sella turcica are seen in both sections. The paper presents findings on the optimal CT evaluation of the above anatomical structures and variations as related to their diagnostic value.

Humans↗

[Preferential habits of consumers of common bean (Phaseolus vulgaris L.) in Mexico].

A detailed knowledge of the consumer's preferences for the different classes of common bean is useful to define objectives in bean breeding and quality projects in a given region or country and it is also a valuable tool to design marketing strategies. The present work consisted on the application of a survey to 1514 common bean consumers in 14 states of Mexico. To facilitate the interpretation of the results the country was divided in four regions: North East, North West, Center and South. In the North West region, 98% of the surveyed individuals eat the "Azufrado" types (sulphur yellow); in the North East, 70% of the consumers prefer "pinto" (beige with brown mottles) and "Bayo" (cream) types; in the South, 90% of the consumers prefer the "Black" type; and in the Center of the country, all commercial classes are consumed. Within a commercial class, specific characteristics are demanded. For instance, in the black type, small and opaque seeds are preferred while in the "Flor de mayo" (Beige with pink mottles) type medium to large seeds having bright seed coat are preferred. The main characteristics utilized by consumers to select a given bean type are cooking time and flavor. It was observed that preferential classes are well established among the consumers since 70% responded that they would not change the preferred class even if the alternative class was sold to a lower price. Consumers do not soak the beans, because it changes the flavor and the aspect of the cooked beans and they do not add salt at the beginning of the cooking process due to the same reason. Organoleptic studies conducted in the laboratory confirmed that soaking of beans or addition of salts in the soaking water or at the beginning of the cooking process negatively affected acceptability of cooked beans by panelists. In this paper aspects related to ways of processing and consuming common beans as well as marketing aspects are discussed.

Fabaceae↗

Risk factors for nonhepatic surgery in patients with cirrhosis.

Cirrhosis of the liver appears to have an unfavorable prognosis in the surgical patient. The aim of this study was to determine risk factors for morbidity and mortality in patients with cirrhosis undergoing nonhepatic surgery. We studied 135 patients with liver cirrhosis undergoing nonhepatic procedures and 86 controls matched by age, sex, and preoperative diagnosis. Preoperative, intraoperative, and postoperative variables associated with 30-day mortality and morbidity were assessed by univariate and multivariate analyses. Patients with cirrhosis showed higher blood transfusion requirements, longer length of hospital stay, and a higher number of complications than controls. The mortality rate was 16.3% in cirrhotics and 3.5% in controls. By univariate analysis, the need for transfusions, prothrombin time, and Child-Pugh score were significantly associated with postoperative liver decompensation, whereas duration of surgery, prothrombin time, Child-Pugh score, cirrhosis-related complications, and general complications were significantly associated with mortality. In the multivariate analysis, Child-Pugh score (odds ratio [OR] 24.4; 95% confidence interval [CI] 5.5 to 106); duration of surgery (OR 5; 95% CI 1.2 to 15.6), and postoperative general complications (OR 3.7; 95% CI 3.4 to 6.4) were independent predictors of mortality. Patients with cirrhosis undergoing nonhepatic operations are at significant risk of perioperative complications leading to death. Independent variables associated with perioperative mortality include preoperative Child-Pugh score, the duration of surgery, and the presence of postoperative general complications.

Aged↗

[Anasarca as presentation of lobular breast carcinoma].

Metastatic tumors in the small intestine are rare. The most commonly implicated primitive tumors are malignant melanoma, lung cancer and colon cancer. Few cases of metastasis to the intestine as the first manifestation of metastasis have been described. We present a case of metastasis to the intestine of lobular breast carcinoma 9 years after surgical resection of the primary tumor. Metastasis presented as anasarca. Ray small bowel series revealed ileal stenosis. Diagnosis was confirmed by histopathologic analysis following surgical resection of the affected intestinal segment.

Breast Neoplasms↗