Glasius bio-inspired neural networks based UV-C disinfection path planning improved by preventive deadlock processing algorithm.

The COVID-19 pandemic made robot manufacturers explore the idea of combining mobile robotics with UV-C light to automate the disinfection processes. But performing this process in an optimum way introduces some challenges: on the one hand, it is necessary to guarantee that all surfaces receive the radiation level to ensure the disinfection; at the same time, it is necessary to minimize the radiation dose to avoid the damage of the environment. In this work, both challenges are addressed with the design of a complete coverage path planning (CCPP) algorithm. To do it, a novel architecture that combines the glasius bio-inspired neural network (GBNN), a motion strategy, an UV-C estimator, a speed controller, and a pure pursuit controller have been designed. One of the main issues in CCPP is the deadlocks. In this application they may cause a loss of the operation, lack of regularity and high peaks in the radiation dose map, and in the worst case, they can make the robot to get stuck and not complete the disinfection process. To tackle this problem, in this work we propose a preventive deadlock processing algorithm (PDPA) and an escape route generator algorithm (ERGA). Simulation results show how the application of PDPA and the ERGA allow to complete complex maps in an efficient way where the application of GBNN is not enough. Indeed, a 58% more of covered surface is observed. Furthermore, two different motion strategies have been compared: boustrophedon and spiral motion, to check its influence on the performance of the robot navigation.

Peri-implant radiographic bone level and associated factors in Spain.

OBJECTIVES: To evaluate radiographic bone level (RxBL) at dental implants and its associated factors in Spain. MATERIAL AND METHODS: This cross-sectional study was performed by a network of sentinel dentists from regions of Spain. RxBL was defined as the distance from the implant shoulder to the first clearly visible contact between the implant surface and the bone. Radiographic measurements were performed by two trained and experienced periodontists. Implant and patient data were also collected. Descriptive, bivariate, discriminative and multivariate analyses were done. RESULTS: A total of 49 sentinel dentists provided data 275 patients. Mean RxBL from 474 implants (5-13 years) was 1.87 mm (range: 0.00-13.17 mm). Statistically significant associations between RxBL and clinical output variables (bleeding on probing, oedema, plaque, probing depth, suppuration, keratinized tissue) were found. In the multiple regression analysis, statistically significant associations for RxBL were found for smoking habit, implant diameter, years of follow-up and type of prosthesis (p < 0.01). CONCLUSIONS: Peri-implant RxBL ranged from 0 to 13.17 mm. It was significantly associated with clinical output variables and with some potentially predictor variables, at patient- (smoking >10 cigarettes/day) and implant- (diameter, years of follow-up, Toronto bridge) levels.

Scalable and Tunable Periodic Graphene Nanohole Arrays for Mid-Infrared Plasmonics.

Despite its great potential for a wide variety of devices, especially mid-infrared biosensors and photodetectors, graphene plasmonics is still confined to academic research. A major reason is the fact that, so far, expensive and low-throughput lithography techniques are needed to fabricate graphene nanostructures. Here, we report for the first time a detailed experimental study on electrostatically tunable graphene nanohole array surfaces with periods down to 100 nm, showing clear plasmonic response in the range ∼1300-1600 cm-1, which can be fabricated by a scalable nanoimprint technique. Such large area plasmonic nanostructures are suitable for industrial applications, for example, surface-enhanced infrared absorption (SEIRA) sensing, as they combine easy design, extreme field confinement, and the possibility to excite multiple plasmon modes enabling multiband sensing, a feature not readily available in nanoribbons or other localized resonant structures.

Prevalence and risk indicators of peri-implant diseases in Spain.

AIM: To evaluate the prevalence of peri-implant diseases in Spain, as well as the associated risk indicators. MATERIAL AND METHODS: This is a cross-sectional study using a network of sentinel dentists, who randomly selected 10 patients with implants (placed, at least, 5 years before), which were clinically and radiographically evaluated. Case definitions were established for peri-implant mucositis [bleeding on probing (BOP) and no bone level ≥2 mm] and peri-implantitis (BOP plus bone level ≥2 mm). Potential predictor variables, at univariate and multivariate levels, were explored by means of binary logistic regression. RESULTS: A total of 49 sentinel dentists provided complete data from 474 implants in 275 patients. At implant level, prevalences for peri-implant mucositis and peri-implantitis were 27% (95% confidence interval [CI] 22-32) and 20% (95% CI: 15-24), respectively, with 17% of implants (14-21) with bone level ≥2 mm without BOP. At patient level, prevalences were 27% (22-32), 24% (19-29) and 18% (13-22), respectively. In the multiple regression analysis, statistically significant associations for peri-implantitis (p < 0.10) were found for gender, peri-implant supportive therapy, implant location, diameter and surface, type of prosthesis and access to interproximal hygiene. CONCLUSIONS: In this representative subject sample across Spain, the prevalence of peri-implant diseases was high (51%).

Infrared Plasmonic Biosensor for Real-Time and Label-Free Monitoring of Lipid Membranes.

In this work, we present an infrared plasmonic biosensor for chemical-specific detection and monitoring of biomimetic lipid membranes in a label-free and real-time fashion. Lipid membranes constitute the primary biological interface mediating cell signaling and interaction with drugs and pathogens. By exploiting the plasmonic field enhancement in the vicinity of engineered and surface-modified nanoantennas, the proposed biosensor is able to capture the vibrational fingerprints of lipid molecules and monitor in real time the formation kinetics of planar biomimetic membranes in aqueous environments. Furthermore, we show that this plasmonic biosensor features high-field enhancement extending over tens of nanometers away from the surface, matching the size of typical bioassays while preserving high sensitivity.

Plasmon-plasmon hybridization and bandwidth enhancement in nanostructured graphene.

Graphene plasmonic structures with long-range layering periodicity are presented. Resonance energy scaling with the number of graphene layers involved in plasmonic excitation allows these structures to support multiple plasmonic modes that couple and hybridize due to their physical proximity. Hybridized states exhibit bandwidth enhancements of 100-200% compared to unhybridized modes, and resonance energies deviate from what is usually observed in coupled plasmonic systems. Origins of this behavior are discussed, and experimental observations are computationally modeled. This work is a precursor and template for the study of plasmonic hybridization in other two-dimensional material systems with layering periodicity.

The telocytes relationship with satellite cells: Extracellular vesicles mediate the myotendinous junction remodeling.

The peripheral nerve injury (PNI) affects the morphology of the whole locomotor apparatus, which can reach the myotendinous junction (MTJ) interface. In the injury condition, the skeletal muscle satellite cells (SC) are triggered, activated, and proliferated to repair their structure, and in the MTJ, the telocytes (TC) are associated to support the interface with the need for remodeling; in that way, these cells can be associated with SC. The study aimed to describe the SC and TC relationship after PNI at the MTJ. Sixteen adult Wistar rats were divided into Control Group (C, n = 8) and PNI Group (PNI, n = 8), PNI was performed by the constriction of the sciatic nerve. The samples were processed for transmission electron microscopy and immunostaining analysis. In the C group was evidenced the arrangement of sarcoplasmic evaginations and invaginations, the support collagen layer with a TC inside it, and an SC through vesicles internally and externally to then. In the PNI group were observed the disarrangement of invaginations and evaginations and sarcomeres degradation at MTJ, as the disposition of telopodes adjacent and in contact to the SC with extracellular vesicles and exosomes in a characterized paracrine activity. These findings can determine a link between the TCs and the SCs at the MTJ remodeling. RESEARCH HIGHLIGHTS: Peripheral nerve injury promotes the myotendinous junction (MTJ) remodeling. The telocytes (TC) and the satellite cells (SC) are present at the myotendinous interface. TC mediated the SC activity at MTJ.

Biological complications and peri-implant clinical and radiographic changes at immediately placed dental implants. A prospective 5-year cohort study.

OBJECTIVES: To evaluate clinically and radiographically immediate implants 5 years after insertion and to compare them with delayed-placed implants in the same subjects. MATERIAL AND METHODS: Twenty-two consecutive patients that needed at least two implants for replacing hopeless teeth, one immediately upon extraction and the other in a delayed fashion (at least 4 months post-extraction) were selected in this prospective cohort study. Post-extraction immediate implants (II) and delayed implants (DI) groups were defined. One and 5 years after implant loading, clinical and radiographical outcome variables were recorded and analysed both at site and at implant level. Intra-group and inter-group comparisons were performed. RESULTS: The intergroup comparison did not show significant differences for plaque index, bleeding on probing and suppuration. These parameters worsen in both groups along the study. This trend was stronger for the plaque index in the group II, which increased from 15.6% at 1 year to 25.9% at 5 years (P < 0.04). One year after loading, the sites with probing depth ≥5 mm were higher for the group II compared to DI (2.5% vs. 0%; P = 0.049). At the end of the study, no significant statistical differences were found. Radiographically, bone crestal changes did not yield significant differences. During the follow-up period, 25% of the implants (26.4% in group II and 23.5% in DI) showed biological complications: mucositis (20%) and/or periimplantitis (5.8%). No differences between groups were found. CONCLUSIONS: Within the same patients, the implants placed with the immediate protocol demonstrated a higher tendency to crestal bone loss and to peri-implantitis, although these differences were not statistically significant.

Surgical protocols for ridge preservation after tooth extraction. A systematic review.

OBJECTIVE: This systematic review aims to evaluate the scientific evidence on the efficacy in the surgical protocols designed for preserving the alveolar ridge after tooth extraction and to evaluate how these techniques affect the placement of dental implants and the final implant supported restoration. MATERIAL AND METHODS: A thorough search in MEDLINE-PubMed, Embase and the Cochrane Central Register of controlled trials (CENTRAL) was conducted up to February 2011. Randomized clinical trials and prospective cohort studies with a follow-up of at least 3 months reporting changes on both the hard and soft tissues (height and/or width) of the alveolar process (mm or %) after tooth extraction were considered for inclusion. RESULTS: The screening of titles and abstracts resulted in 14 publications meeting the eligibility criteria. Data from nine of these 14 studies could be grouped in the meta-analyses. Results from the meta-analyses showed a statistically significant greater ridge reduction in bone height for control groups as compared to test groups (weighted mean differences, WMD = -1.47 mm; 95% CI [-1.982, -0.953]; P < 0.001; heterogeneity: I(2) = 13.1%; χ(2) P-value = 0.314) and a significant greater reduction in bone width for control groups compared to the test groups (WMD = -1.830 mm; 95% CI [-2.947, -0.732]; P = 0.001; heterogeneity: I(2) = 0%; χ(2) P-value = 0.837). Subgroup analysis was based on the surgical protocol used for the socket preservation (flapless/flapped, barrier membrane/no membrane, primary intention healing/no primary healing) and on the measurement method utilized to evaluate morphological changes. Meta-regression analyses demonstrated a statistically significant difference favoring the flapped subgroup in terms of bone width (meta-regression; slope = 2.26; 95% IC [1.01; 3.51]; P = 0.003). CONCLUSIONS: The potential benefit of socket preservation therapies was demonstrated resulting in significantly less vertical and horizontal contraction of the alveolar bone crest. The scientific evidence does not provide clear guidelines in regards to the type of biomaterial, or surgical procedure, although a significant positive effect of the flapped surgery was observed. There are no data available to draw conclusions on the consequences of such benefits on the long-term outcomes of implant therapy.

Chemical vs. Enzymatic Refining to Produce Peanut Oil for Edible Use or to Obtain a Sustainable and Cost-Effective Protector for Stored Grains against Sitophilus zeamais (Coleoptera: Curculionidae).

Among the various existing techniques, enzymatic degumming represents a process that is establishing itself as a valid alternative to the more classic chemical processes. Moreover, vegetable oils of various origins have been gaining more consideration as sustainable and affordable protectants for cereals and pulses against the attack of several insect pests. Sitophilus zeamais (Motschulsky) (Coleoptera: Curculionidae) is one of the key pests of cereal crops in the field and in stored and processed cereal products. Based on these highlighted issues, the overall aim of this research was twofold: (i) firstly, the effectiveness of the enzymatic degumming process was evaluated through the use of three different enzymes in order to verify the possible industrial application within the SALOV company as an alternative to the conventional chemical process; (ii) in a second phase, the possible use of the innovative refined oils was explored for sustainable stored grain protection towards S. zeamais. The results obtained confirm the strong possibility of applying the enzymatic process, which is innovative and, in a chemical way, more sustainable than the classical one. Regarding the toxicity towards S. zeamais, the crude peanut oil and the chemically refined peanut oil had lower LC50 values (1.836 and 1.372 g kg-1, respectively) than the oils rectified through enzymatic degumming (LC50 from 2.453 to 4.076 g kg-1), and, therefore, they can be suggested as sustainable stored grain protectants.

Andean Plants Essential Oils: A Scented Alternative to Synthetic Insecticides for the Control of Blowflies.

Blowflies are vectors of microorganisms and human pathogens, and their maggots cause myiasis in vertebrates and infest and spoil meat and fish products. Essential oils (EOs) from spices were proven to be a safer and more sustainable alternative to synthetic insecticides for the control of blowflies and are suitable for protecting food from such pests. However, some EOs are not acceptable for environmental or topical applications due to their strong, unpleasant odour. In this study, we measured the acute toxicity and the repellence of two EOs extracted from the Andean plants Aloysia citrodora Palau and Bursera graveolens (Kunth) Triana and Planch., both known for their pleasant odour, against the blue blowfly Calliphora vomitoria (L.) (Diptera: Calliphoridae). We also compared their bioactivity with that of the Allium sativum L. EO, which is very effective but bad-smelling. The A. citrodora EO was mainly rich in oxygenated monoterpenes, the most abundant of which were geranial (26.8%) and neral (21.0%). The B. graveolens EO was chiefly composed of monoterpene hydrocarbons, mostly represented by limonene (46.2%). According to the sensory description, the best odour profile was associated with the A. citrodora EO, while the olfactory expression of the EO from B. graveolens was negatively affected by a strong odour of "mouldy lemon". The behavioural test showed that the A. citrodora EO was more repellent than that of A. sativum and, on the contrary, that the B. graveolens EO was attractive. The toxicity tests showed that the EOs of both Andean plants have a clear toxic effect on the C. vomitoria eggs and adults. In terms of ovicidal activity, there were no significant differences among the effects of the three tested EOs. On the adult flies, the toxicity of the two EOs of the Andean plants was much lower than that of A. sativum (LC50 fumigation = 1.86 µL EO L-1 air; LC50 ingestion = 8.10 µL EO mL-1 gel) both by fumigation (LC50 = 23.66 and 25.30 µL EO L-1 air for A. citrodora and B. graveolens, respectively) and ingestion (LC50 = 36.65 and 44.97 µL EO mL-1 gel for A. citrodora and B. graveolens, respectively), while, by contact, the A. citrodora EO (LD50 = 0.27 µL EO insect-1) was more toxic than the A. sativum EO (LD50 = 0.46 µL EO insect-1).

Antineoplastic Activity of Rhus trilobata Nutt. (Anacardiaceae) against Ovarian Cancer and Identification of Active Metabolites in This Pathology.

Rhus trilobata (RHTR) is a medicinal plant with cytotoxic activity in different cancer cell lines. However, the active compounds in this plant against ovarian cancer are unknown. In this study, we aimed to evaluate the antineoplastic activity of RHTR and identify its active metabolites against ovarian cancer. The aqueous extract (AE) and an active fraction (AF02) purified on C18-cartridges/ethyl acetate decreased the viability of SKOV-3 cells at 50 and 38 µg/mL, respectively, compared with CHO-K1 (>50 µg/mL) in MTT assays and generated changes in the cell morphology with apoptosis induction in Hemacolor® and TUNEL assays (p ≤ 0.05, ANOVA). The metabolite profile of AF02 showed a higher abundance of flavonoid and lipid compounds compared with AE by UPLC-MSE. Gallic acid and myricetin were the most active compounds in RHTR against SKOV-3 cells at 50 and 166 µg/mL, respectively (p ≤ 0.05, ANOVA). Antineoplastic studies in Nu/Nu female mice with subcutaneous SKOV-3 cells xenotransplant revealed that 200 mg/kg/i.p. of AE and AF02 inhibited ovarian tumor lesions from 37.6% to 49% after 28 days (p ≤ 0.05, ANOVA). In conclusion, RHTR has antineoplastic activity against ovarian cancer through a cytostatic effect related to gallic acid and myricetin. Therefore, RHTR could be a complementary treatment for this pathology.

Diagnosis of implant stability and its impact on implant survival: a prospective case series study.

OBJECTIVES: To assess the predictability of implant stability assessment either clinically or by resonance frequency analysis (RFA). MATERIAL AND METHODS: This prospective case series study evaluated 4114 consecutive SLA Straumann implants in two private clinics. Primary stability was classified in four categories, depending on the degree of implant rotation when tightening the healing cap: A (no rotation at all), B (light rotation with a feeling of resistance), C (rotation without resistance) and D (rotation and lateral oscillation). In one clinic (n=542 implants), RFA method was also used the day of the surgery (Osstell 1) and at restoration placement (Osstell 2). Survival rates were stratified according to the clinical classification categories using life table analysis. The association between Osstell 1 and 2 and the clinical classification was tested with ANOVA. RESULTS: 3899 implants were classified as stable (A) and 213 as unstable (B-D). Their survival rates were 99.1% and 97.2%, respectively. The unstable implants were further classified in B (158), C (51) and D (4), with survivals of 98.1%, 94.1% and 100%, respectively, being these differences statistically significant (P<0.009). Using Osstell, implants were stratified in two groups according to a predefined threshold of implant stability quotient (>or=60). At the Osstell 1 measurement there was no significant association between primary stability and implant survival (P<0.753). In Osstell 2, however, the association was significant (P<0.001). CONCLUSIONS: Only secondary stability RFA values were able to significantly predict implant outcomes, but not primary stability values. There was a good correlation between RFA and the proposed clinical classification of primary stability.

Effect of Gallic acid and Myricetin on ovarian cancer models: a possible alternative antitumoral treatment.

BACKGROUND: Ovarian cancer is the leading cause of mortality among malignant gynecological tumors. Surgical resection and chemotherapy with intravenous platinum/taxanes drugs are the treatments of choice, with little effectiveness in later stages and severe toxicological effects. Therefore, this study aimed to evaluate the antineoplastic activity of gallic acid (GA) and myricetin (Myr) administrated peritumorally in Nu/Nu mice xenotransplanted with SKOV-3 cells. METHODS: Biological activity of GA and MYR was evaluated in SKOV-3 and OVCAR-3 cells (ovarian adenocarcinomas) by confocal/transmission electron microscopy, PI-flow cytometry, H2-DCF-DA stain, MTT, and Annexin V/PI assays. Molecular targets of compounds were determined with ACD/I-Labs and SEA. Antineoplastic activity was performed in SKOV-3 cells subcutaneously xenotransplanted into female Nu/Nu mice treated peritumorally with 50 mg/kg of each compound (2 alternate days/week) for 28 days. Controls used were paclitaxel (5 mg/kg) and 20 µL of vehicle (0.5% DMSO in 1X PBS). Tumor lesions, organs and sera were evaluated with NMR, USG, histopathological, and paraclinical studies. RESULTS: In vitro studies showed a decrease of cell viability with GA and Myr in SKOV-3 (50 and 166 µg/mL) and OVCAR-3 (43 and 94 µg/mL) cells respectively, as well as morphological changes, cell cycle arrest, and apoptosis induction due to ROS generation (p ≤ 0.05, ANOVA). In silico studies suggest that GA and MYR could interact with carbonic anhydrase IX and PI3K, respectively. In vivo studies revealed inhibitory effects on tumor lesions development with GA and MYR up to 50% (p ≤ 0.05, ANOVA), with decreased vascularity, necrotic/fibrotic areas, neoplastic stroma retraction and apoptosis. However, toxicological effects were observed with GA treatment, such as leukocyte infiltrate and hepatic parenchyma loss, hypertransaminasemia (ALT: 150.7 ± 25.60 U/L), and hypoazotemia (urea: 33.4 ± 7.4 mg/dL), due to the development of chronic hepatitis (p ≤ 0.05, ANOVA). CONCLUSION: GA and Myr (50 mg/kg) administered by peritumoral route, inhibit ovarian tumor lesions development in rodents with some toxicological effects. Additional studies will be necessary to find the appropriate therapeutic dose for GA. Therefore, GA and Myr could be considered as a starting point for the development of novel anticancer agents.

Natural history of experimental arthritis induced by Paracoccidioides brasiliensis in wistar rats.

INTRODUCTION: Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Latin America. This study aimed to evaluate the natural history of Paracoccidioides brasiliensis-induced experimental arthritis of the knee joints in Wistar rats. METHODS: Rats were randomly allocated to either an absolute control group, or 15-day, 45-day, or 90-day experimental (fungus-inoculated) groups. RESULTS: Experimental groups developed classic signs of articular PCM. Titers of anti-gp43 were observed to increase during the interval from 15 to 45 days post-inoculation. CONCLUSIONS: Articular arthritic lesions were induced and progressed during the study period in all experimental groups.

Study on the obtaining of Tityus trivittatus venom in Argentina.

Envenomation by scorpions of the genus Tityus is an important public health problem in Argentina, involving near 8000 stings and 2 deaths each year. Treatment for envenomation is the use of specific antivenom and intensive hospital care. Antivenom is produced by the Ministry of Health and freely distributed throughout the country. For antivenom production it is necessary to collect scorpion venom, which is a difficult task because although scorpions can be found in Argentina, they are less abundant than in warmer latitudes. For this reason venom collection constitutes a bottleneck for antivenom production. Although in Argentina several species of Tityus can be found, most of the accidents are caused by Tityus trivittatus, and the venom of this scorpion has historically been the venom used for antivenom production. We analyzed retrospectively 26 pools of telson homogenates (6964 telsons) and 37 pools of milked venom obtained by electrical stimulation (equivalent to 6841 milkings). Lethal potencies of samples from different provinces were very similar, although venom from scorpions of Buenos Aires city showed the lowest potency. The venom obtained by milking (median LD50 12.3 µg), provided batches containing LD50s more potent when compared with the venom obtained from telson homogenates (p < 0.0001). Many batches of telson homogenates (30%) showed lower potencies than acceptable for antivenom production and control. In addition to the study of the venom yield, the records of immunization of horses, the potency of the batches and the protein content of each batch of anti-scorpion antivenom produced were analyzed, comparing those produced using milked venom with those using telson homogenates as immunogens. Batches produced using milked venom required a shorter period of immunization (p < 0.0001), rendered higher neutralizing titers (p 0.0350) and possessed lower protein content (p 0.0092). Results clearly showed that the milking of scorpions is a more efficient tool to obtain venom for antivenom production in comparison to the use of telson homogenates.

Resolving molecule-specific information in dynamic lipid membrane processes with multi-resonant infrared metasurfaces.

A multitude of biological processes are enabled by complex interactions between lipid membranes and proteins. To understand such dynamic processes, it is crucial to differentiate the constituent biomolecular species and track their individual time evolution without invasive labels. Here, we present a label-free mid-infrared biosensor capable of distinguishing multiple analytes in heterogeneous biological samples with high sensitivity. Our technology leverages a multi-resonant metasurface to simultaneously enhance the different vibrational fingerprints of multiple biomolecules. By providing up to 1000-fold near-field intensity enhancement over both amide and methylene bands, our sensor resolves the interactions of lipid membranes with different polypeptides in real time. Significantly, we demonstrate that our label-free chemically specific sensor can analyze peptide-induced neurotransmitter cargo release from synaptic vesicle mimics. Our sensor opens up exciting possibilities for gaining new insights into biological processes such as signaling or transport in basic research as well as provides a valuable toolkit for bioanalytical and pharmaceutical applications.

Disección carotídea espontánea: Presentación de un caso clínico con revisión de la literatura / Carotid Artery Dissection. Case Report and Literature Review

Resumen Introducción: La disección carotídea consiste en el desgarro de la pared del vaso. Es una patología infrecuente, pero es la causa más común de enfermedad vascular cerebral (EVC) isquémica en personas menores de 45 años. Las manifestaciones clínicas son muy variables. Método: Utilizamos las recomendaciones CARE para el reporte de casos clínicos. Caso clínico: Hombre de 45 años previamente sano, con debilidad aguda de la extremidad torácica derecha sin causa aparente. La tomografía simple de cráneo no evidenció alteraciones. La resonancia magnética mostró una oclusión completa de la arteria carótida interna en todos sus segmentos y disminución del flujo de la arteria cerebral media izquierda. La evolución clínica fue desfavorable. Conclusión: La disección carotídea debe sospecharse en personas con EVC sin factores de riesgo cardiovascular.

Abstract Introduction: Carotid dissection consists of a tear in the vessel wall. It is a rare pathology, but it is the most common cause of ischemic cerebral vascular disease (CVD) in people under 45 years of age. The clinical manifestations are very variable. Method: We used CARE recommendations for reporting clinical cases. Clinical case: Previously, a healthy 45-year-old man with acute weakness of the right thoracic extremity without apparent cause. The simple skull tomography did not show any alterations. MRI showed complete occlusion of the internal carotid artery in all its segments and decreased flow of the left middle cerebral artery. The clinical evolution was unfavorable. Conclusion: Carotid dissection should be suspected in people with CVD without cardiovascular risk factors.

Perfil epidemiológico, clínico e microbiológico de infecções por bactérias do grupo eskape em pacientes internados em uma unidade de terapia intensiva de um hospital de ensino de Minas Gerais / Epidemiological, clinical and microbiological profile of eskape group bacteria infections in patients admitted to an intensive care unit of a teaching hospital in Minas Gerais / Perfil epidemiológico, clínico y microbiológico de las infecciones por bacterias del grupo eskape en pacientes ingresados en una unidad de cuidados intensivos de un hospital escuela de Minas Gerais

Objetivo: descrever o perfil epidemiológico de infecções por bactérias do grupo ESKAPE em pacientes internados em uma unidade de terapia intensiva de um hospital de ensino da cidade de Juiz de Fora - MG. Métodos: Trata-se de um estudo epidemiológico observacional, descritivo de caráter retrospectivo, com participantes que adquiriram IRAS entre 2017 e 2018, dos quais foram isoladas e identificadas linhagens bacterianas pertencentes ao grupo ESKAPE no serviço de rotina bacteriológica do laboratório de microbiologia clínica. Resultados: Considerando o fenótipo de multirresistência entre as bactérias do grupo ESKAPE avaliadas, foi observada a ocorrência de 122 (88,4%) para Acinetobacter baumanii resistente aos carbapenêmicos, 87 (60,8%) para Klebsiella pneumoniae resistente aos carbapenêmicos, 57 (53,3%) para Pseudomonas aeruginosa resistente aos carbapenêmicos, 36 (55,4%) para MRSA e 19 (48,7%) para Enterobacter sp. resistente aos carbapenêmicos. Conclusões: A análise do perfil epidemiológico, clínico e microbiológico de infecções por bactérias do grupo ESKAPE em pacientes internados em uma UTI é de majorada importância para protocolos de terapia com o correto manejo de antibioticoterapia e redução da prevalência de resistência antimicrobiana.

Objective: To describe the epidemiological profile of ESKAPE group bacteria infections in patients admitted to an intensive care unit of a teaching hospital in Juiz de Fora, Minas Gerais. Methods: This is an observational, descriptive epidemiological study of retrospective nature, with participants who acquired IRAS between 2017 and 2018, from which bacterial strains belonging to the ESKAPE group were isolated and identified in the bacteriological routine service of the clinical microbiology laboratory. Results: Considering the multidrug resistance phenotype among the ESKAPE group bacteria evaluated, the occurrence of 122 (88.4%) for carbapenem- resistant Acinetobacter baumanii, 87 (60.8%) for carbapenem-resistant Klebsiella pneumoniae, 57 (53.3%) for carbapenem-resistant Pseudomonas aeruginosa, 36 (55.4%) for MRSA, and 19 (48.7%) for carbapenem-resistant Enterobacter sp. was observed. Conclusions: The analysis of the epidemiological, clinical and microbiological profile of infections caused by bacteria of the ESKAPE group in patients in an ICU is of major importance for therapy protocols with the correct management of antibiotic therapy and reduction of the prevalence of antimicrobial resistance.

Objetivo: Describir el perfil epidemiológico de las infecciones por bacterias del grupo ESKAPE en pacientes internados en la unidad de terapia intensiva de un hospital escuela de Juiz de Fora, Minas Gerais. Método: Se trata de un estudio epidemiológico observacional, descriptivo, de carácter retrospectivo, con participantes que adquirieron IRAS entre 2017 y 2018, de los cuales se aislaron e identificaron cepas bacterianas pertenecientes al grupo ESKAPE en el servicio de rutina bacteriológica del laboratorio de microbiología clínica. Resultados: Considerando el fenotipo de resistencia a múltiples fármacos entre las bacterias del grupo ESKAPE evaluadas, se observó la ocurrencia de 122 (88,4%) para Acinetobacter baumanii resistente a carbapenemes, 87 (60,8%) para Klebsiella pneumoniae resistente a carbapenemes, 57 (53,3%) para Pseudomonas aeruginosa resistente a carbapenemes, 36 (55,4%) para MRSA y 19 (48,7%) para Enterobacter sp. resistente a carbapenemes. Conclusiones: El análisis del perfil epidemiológico, clínico y microbiológico de las infecciones causadas por bacterias del grupo ESKAPE en pacientes ingresados en una UCI es de gran importancia para los protocolos terapéuticos con el correcto manejo de la antibioticoterapia y la reducción de la prevalencia de resistencias antimicrobianas.

Mastectomia preventiva em situações de câncer de mama precoce / Preventive mastectomy in situations of early breast cancer: an integrative review

A mastectomia preventiva relacionada às neoplasias de mama precoces é um tema de grande importância na área da oncologia, especialmente para mulheres com alto risco genético de desenvolver câncer de mama. Objetivo: Descrever como a mastectomia relaciona-se com a prevenção de neoplasias de mama precoces. Métodos: Trata-se de uma revisão integrativa da literatura. Para construção da pesquisa, a coleta e análise de dados foi realizada através do Portal da Biblioteca Virtual da Saúde e da base de dados Medical Literature Analysis and Retrievel System Online via PubMed, através dos Descritores em Ciências da Saúde (DeCS): "Mastectomia Profilática", "Neoplasias da Mama" e "Fatores de Risco" combinados entre si pelo operador booleano AND. Como critérios de inclusão: estudos relacionados à temática excluindo-se as revisões de literatura, com delimitação temporal dos últimos cinco anos, nos idiomas inglês, português e espanhol. A questão norteadora foi construída com base na estratégia PICo de acordo com a descrição (População, Interesse e Contexto). Resultados: Foram encontrados 76 artigos, destes 64 foram excluídos devido aos filtros utilizados e a leitura dos resumos e na íntegra, restando apenas 12 estudos para compor a amostra final. Em suma, os estudos demonstram que a mastectomia preventiva pode oferecer às mulheres com alto risco genético uma opção para reduzir suas chances de desenvolver câncer de mama. Conclusão: A mastectomia preventiva relacionada às neoplasias de mama precoces é uma opção terapêutica complexa e individualizada, que busca reduzir o risco de desenvolvimento ou recorrência do câncer de mama em mulheres de alto risco

: Preventive mastectomy related to early breast neoplasms is a topic of great concern in the field of oncology, especially for women with a high genetic risk of developing breast cancer. Objective: To describe how mastectomy is related to the prevention of early breast cancer. Methods: This is an integrative literature review. For the construction of the research, data collection and analysis was carried out through the Virtual Health Library Portal and the Medical Literature Analysis and Retrievel System Online database via PubMed, through the Health Sciences Descriptors (DeCS): "Prophylactic Mastectomy","Breast Neoplasms" and "Risk Factors" combined with the Boolean AND operator. As inclusion criteria: studies related to the theme excluding literature reviews,with publication time delimitation of the last five years, in English, Portuguese and Spanish. The research question was structured based on the PICo strategy according to the description (Population, Interest and Context). Results: 76 articles were found, of which 64 were excluded after the filters application. We performed the reading of abstracts and full text, and 12 studies were selected to compose the final sample. In summary, studies demonstrate that preventive mastectomy can offer women at high genetic risk an option to reduce their chances of developing breast cancer. Conclusion: Preventive mastectomy related to early breast neoplasms is a complex and individualized therapeutic option that seeks to reduce the risk of breast cancer development or recurrence in high-risk women