An Inflammatory Fibroid Polyp in the Hepatic Flexure of the Colon Treated with Argon Plasma Coagulation, Endoscopic Clipping and Polypectomy

Inflammatory fibroid polyp (IFP) is a rare benign polypoid lesion of the gastrointestinal tract. Most IFPs occur in the stomach and colonic occurrence is very rare. Histologically IFP is characterized by a mixture of numerous small vessels, fibroblasts and edematous connective tissue associated with marked inflammatory infiltration by eosinophils. We present a rare case of a pedunculated IFP in the hepatic flexure of the colon treated successfully with a combination of argon plasma coagulation, endoclipping and polypectomy. A 74-year-old asymptomatic female underwent a screening colonoscopy in our hospital. A 12-mm pedunculated polyp was found at the hepatic flexure of the colon. After saline injection, we attempted to remove the polyp with a hot snare. However the polyp stalk was extremely difficult to resect despite several attempts with the hot snare. We placed an endoclip at the base of the stalk and then applied argon plasma coagulation at 1.0 l/min and 40 W. After these measures we were able to resect the stalk and the polyp was retrieved. Histologically the polyp was located in the submucosa of the gastrointestinal tract. Proliferation of spindle cells and infiltration of inflammatory cells such as plasma cells and eosinophils were observed. The spindle cells were positive for CD34 and S100 but negative for c-kit and muscle markers. These findings are consistent with a histopathological diagnosis of IFP

Geographical distribution of salmonella infected pig, cattle and sheep herds in Sweden 1993-2010

<p>Abstract</p> <p>Background</p> <p>The Swedish salmonella control programme covers the entire production chain, from feed to food. All salmonella serotypes are notifiable. On average, less than 20 cases of salmonella in food-producing animals are reported every year. In some situations, the cases would be expected to cluster geographically. The aim of this study was to illustrate the geographic distribution of the salmonella cases detected in pigs, cattle and sheep.</p> <p>Methods</p> <p>Data on all herds with pigs, cattle and sheep found to be infected with salmonella during the time period from 1993 to 2010 were obtained from the Swedish Board of Agriculture. Using the ArcGIS software, various maps were produced of infected herds, stratified on animal species as well as salmonella serotype. Based on ocular inspection of all maps, some were collapsed and some used separately. Data were also examined for temporal trends.</p> <p>Results</p> <p>No geographical clustering was observed for ovine or porcine cases. Cattle herds infected with Salmonella Dublin were mainly located in the southeast region and cattle herds infected with Salmonella Typhimurium in the most southern part of the country. Some seasonal variation was seen in cattle, but available data was not sufficient for further analyses.</p> <p>Conclusions</p> <p>Analyses of data on salmonella infected herds revealed some spatial and temporal patterns for salmonella in cattle. However, despite using 18 years' of data, the number of infected herds was too low for any useful statistical analyses.</p

Landesque capital as an alternative to food storage in Melanesia: Irrigated taro terraces in New Georgia, Solomon Islands

In the Pacific islands, subsistence diversity made possible continuous production of food while welldeveloped exchange networks redistributed these foodstuffs as well as items within the prestige economy. All these were aspects of the ‘storage structures’ that enabled social and nutritional value to be saved, accumulated and later mobilised. In addition, there were investments in the land, landesque capital, which secured future food surpluses and so provided an alternative to food storage, in a region where the staple foods were mostly perishable, yams excepted, and food preservation was difficult. Landesque capital included such long-term improvements to productivity as terraces, mounds, irrigation channels, drainage ditches, soil structural changes and tree planting. These investments provided an effective alternative to food storage and made possible surplus production for exchange purposes. As an example, in the New Georgia group of the western Solomon Islands irrigated terraces, termed ruta, were constructed for growing the root crop taro (Colocasia esculenta). Surplus taro from ruta enabled inland groups to participate in regional exchange networks and so obtain the shell valuables that were produced by coastal groups. In this paper, we reconstruct how this exchange system worked in New Georgia using ethno-archaeological evidence, we chart its prehistoric rise and post-colonial fall, and we outline the factors that constrained its long-term expansion.Our gratitude for support during earlier fieldwork in the New Georgia group has already been expressed in previous publications. The 2014 project was supported by the Smuts Fund and Foreign Travel Fund, University of Cambridge, and by St John’s College, Cambridge.This is the accepted manuscript. The final version is available from Maney at http://dx.doi.org/10.1179/1749631414Y.000000004

Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

<p>Abstract</p> <p>Background</p> <p>The first outbreak of methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010.</p> <p>Method</p> <p>This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by <it>spa</it>-typing and pulsed-field gel electrophoresis (PFGE) were performed.</p> <p>Results</p> <p>Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.</p> <p>Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA <it>spa</it>-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases.</p> <p>Conclusions</p> <p>Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.</p