BK polyomavirus has been linked to urothelial carcinoma in immunosuppressed patients. Here, we performed comprehensive genomic analysis of a BK polyomavirus-associated, metachronous, multifocal and metastatic micropapillary urothelial cancer in a kidney transplant recipient. Dissecting cancer heterogeneity by sorting technologies prior to array-comparative genomic hybridization followed by short tandem repeat analysis revealed that the metastatic urothelial cancer was of donor origin (4-year-old male). The top 50 cancer-associated genes showed no key driver mutations as assessed by next-generation sequencing. Whole genome sequencing and BK polyomavirus-specific amplification provided evidence for episomal and subgenomic chromosomally integrated BK polyomavirus genomes, which carried the same unique 17-bp deletion signature in the viral non-coding control region (NCCR). Whereas no role in oncogenesis could be attributed to the host gene integration in chromosome 1, the 17-bp deletion in the NCCR increased early viral gene expression, but decreased viral replication capacity. Consequently, urothelial cells were exposed to high levels of the transforming BK polyomavirus early proteins large tumour antigen and small tumour antigen from episomal and integrated gene expression. Surgery combined with discontinuation of immunosuppression resulted in complete remission, but sacrificed the renal transplant. Thus, this report links, for the first time, BK polyomavirus NCCR rearrangements with oncogenic transformation in urothelial cancer in immunosuppressed patients. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Objectives: Inform the recent advances of our early arthritis clinics network program sponsored by The Colombian Rheumatology Association (CRA) to this date. Methods: We asked rheumatologist to participate in a network of early arthritis clinics with the compromise of develop integrated policies and to fill similar standardized questionnaires in our centers and to respect decisions of general assembly of CRA. The CRA finance computers, software for data recollection (Arthros 6.1), and a visit lo Leiden Arthritis Clinic by representatives of each EAC besides of the Colombian protocol and early arthritis registry. Results: These are some achievements: We have completed evidence based clinical guidelines for rheumatoid arthritis, early rheumatoid arthritis, osteoarthritis and Ankylosing Spondylitis; we create a national network of early arthritis with 10 excellence centers trough the country in all major cities in which are working more than 57% of Colombian rheumatologists. They work in assistance to patients with similar policies trough the country and in to research. We are enrolling patients in "Cooperar" (Colombian protocol and Early Arthritis Registry) which consist in a standardized protocol and questionnaire with evaluations each 3 months of patients with early arthritis of less of one year of onset. We have included since May 2005 until know 158 patients. Conclusion: CRA helps to integrate rheumatologist of all around the country and permits to share unified work and protocols which are very important in current health system. Actually our guidelines are official papers for our health system and we hope results of Cooperar will help to establish early arthritis as a national policy in the care of rheumatic diseases. It permits significant collaborative work for the country in areas of low budget or few centers for research.Objectives: Describe frequency and characteristics of disability in a cohort of patients with RA in a population of Colombia. Methods: A Cross-sectional descriptive study in a cohort of patients that attend a University Hospital, a HMO rheumatology clinic and a private office. Consecutive patients with RA according ACR criteria who assist to the clinics were invited participate. A structured questionnaire with sociodemographic, work related information and disease related variables were evaluated. The disability was evaluated by means of the application of the Health Assessment Questionnaire (HAQ). The data were analyzed with the statistical software EPINFO 6.1. Results: To date 88 patients were included, 92% women, 73% mestizos, 53.5% low socioeconomic status (SES), 35.3% medium SES and 11.4% high SES. 59% refer incomes of 1 or fewer minimum wages (150 US), 23% 2 to 3 minimum wage (250 -350 US) and 18% more than 450 US. 71% they have a routine moderate physical activity. The HAQ average was 0.69 Ϯ 0.73 (0 -3); 51% they had HAQs of 0 -0.049, 22.7% of 0.5-0.99, 12.5% of 1-1.49, 5.7% of 1.5-1.99 and 8% of 2-3. Only 27.3% have formal employment with moderate physical activity in most patient...