Microbial life in slow and stopped lanes.

Microbes in nature often lack nutrients and face extreme or widely fluctuating temperatures, unlike microbes in growth-optimized settings in laboratories that much of the literature examines. Slowed or suspended lives are the norm for microbes. Studying them is important for understanding the consequences of climate change and for addressing fundamental questions about life: are there limits to how slowly a cell's life can progress, and how long cells can remain viable without self-replicating? Recent studies began addressing these questions with single-cell-level measurements and mathematical models. Emerging principles that govern slowed or suspended lives of cells - including lives of dormant spores and microbes at extreme temperatures - are re-defining discrete cellular states as continuums and revealing intracellular dynamics at new timescales. Nearly inactive, lifeless-appearing microbes are transforming our understanding of life.

Innovative Methodology for Strengthening a Multidisciplinary Team Approach in Cities in Low- and Middle-Income Countries.

PURPOSE: Delivering high-quality cancer care to patients through a multidisciplinary team (MDT) care approach remains a challenge, particularly in low- and middle-income countries characterized by fragmented health systems and limited human resources for cancer care. City Cancer Challenge (C/Can) is supporting cities in low- and middle-income countries as they work to improve access to equitable quality cancer care. C/Can has developed an innovative methodology to address the MDT gap, piloted in four cities-Asunciòn, Cali, Kumasi, and Yangon. METHODS: Collaborating with a network of partners, C/Can and ASCO have developed a package of technical cooperation support focusing on two priority areas that have emerged as core needs: first developing consensus-based, city-wide patient management guidelines for the most common cancers and second, building capacity for the implementation of MDTs in institutions providing cancer care in the city. RESULTS: The real-time application of C/Can's MDT approach in Cali and Asuncion underlined the importance of engaging the right stakeholders early on and embedding MDT guidelines in local and national regulatory frameworks to achieve their sustainable uptake. The results in Cali and Asuncion were essential for informing the process in Yangon, asserting the clear benefits of city-to-city knowledge exchange. Finally, the global COVID-19 pandemic prompted a rapid adaptation of the methodology from an in-person to virtual format; the unexpected success of the virtual program in Kumasi has led to its application in subsequent C/Can cities. CONCLUSION: The application of C/Can's methodology in this first set of cities has reinforced not only the importance of both resource appropriate guidelines and a highly trained health workforce but also the need for commitment to work across institutions and disciplines.

Prefrontal cortex nicotinic receptor inhibition by methyllycaconitine impaired cocaine-associated memory acquisition and retrieval.

Cocaine administration has been shown to induce plastic changes in the medial prefrontal cortex (mPFC), which could represent a mechanism by which cocaine facilitates the association between cocaine rewarding effects with contextual cues. Nicotinic acetylcholine receptors (nAChRs) in the mPFC have critical roles in cognitive function including attention and memory and are key players in plasticity processes. However, whether nAChRs in the mPFC are required for the acquisition and maintenance of cocaine-associated memories is still unknown. To assess this question, we used the conditioning place preference (CPP) model to study the effect of intra-mPFC infusion of methyllycaconitine, a selective antagonist of α7 nAChRs, on the acquisition, consolidation and expression of cocaine-associated memory in adult rats. Our findings reveal that mPFC α7 nAChRs activation is necessary for the acquisition and retrieval, but not consolidation, of cocaine induced CPP. Moreover, cocaine-induced sensitization during CPP conditioning sessions was abolished by methyllycaconitine infusion in the mPFC. Together, these results identify mPFC α7 nAChRs as critical players involved in both acquiring and retrieving cocaine-associated memories. Considering that drug seeking often depends on the association between drug-paired cues and the rewarding effects of the drug, α7 nAChRs in the mPFC could be considered as potential targets for the prevention or treatment of cocaine use disorder.

Management of non-invasive tumours, benign tumours and breast cancer during the COVID-19 pandemic: recommendations based on a Latin American survey.

INTRODUCTION: The COVID-19 pandemic has changed health systems across the world, both in general hospitals and in oncology institutes or centres.For cancer specialists, particularly breast cancer (BC), the COVID-19 pandemic represents a combination of challenges since the hospital resources and staff have become more limited; this has obliged oncology specialists to seek a consensus and establish which patients with BC require more urgent attention and which patients can wait until there is a better control of this pandemic. The health system in Latin America has some special characteristics; in some of the countries, there are shortages which limit access to several specialities (surgery, clinical oncology and radiotherapy) in some regions. OBJECTIVE: After a systematic review of the most recent literature regarding the management of BC during the COVID-19 pandemic, the main objective is to understand the position of the different Latin American Societies of Mastology in terms of available alternatives for the treatment of BC. METHODS: After carrying out a comprehensive and exhaustive search of the most recent guides on the management of BC during the COVID-19 pandemic, the board members of the Latin American Federation of Mastology invited, via email, different specialists, all experts in BC care, to complete an anonymous survey online.The survey was distributed between 30 and 10 May 2020. The survey included 27 questions on four topics: demographic information, consultations, imaging and treatment of BC.The questionnaire was sent and then distributed to various health specialists including breast surgeons, clinical oncologists, radiation oncologists and radiologists via the Presidents of the different Latin American Societies of Mastology in 18 countries. The results are summarised as tallies based on the number of responses to each question. RESULTS: A total of 499 responses were received. The majority of the respondents were males (275 (55.11%)); 290 participants were over 45 years (58.11%).The questionnaire presented those surveyed with three possible answers (agree, disagree and neither agree nor disagree). The results reflect that there was consensus in the majority of situations presented. Only seven questions revealed disagreement among those responding. The results are presented as recommendations. CONCLUSION: The management of patients with BC presents unique challenges during the current world health situation produced by COVID-19 pandemic. Breast care specialists (surgical oncologists, breast care clinicians, clinical oncologists, radiation oncologists and radiologists) from 18 countries in Central and South America submitted through their responses and recommendations for the treatment of BC during the COVID-19 pandemic.

Plastia en J: opción reparadora en cáncer de mamas / Breast cancer: repair option by J thecnique

El tratamiento quirúrgico es uno de los pilares en el manejo del cáncer mamario. Las indicaciones de gestos conservadores han crecido con el avance de las técnicas oncoplásticas que permiten la resección de mayores volúmenes mientras mantienen o mejoran los resultados estéticos. Presentamos nuestra experiencia y descripción de la plastia en J, técnica versátil y reproductible para reconstrucciones parciales, aplicable en tumores de todos los cuadrantes mamarios. Veinte y nueve pacientes fueron sometidas a una cirugÍa conservadora (2 TUM, 28 CUAD), seguidas de reparación plástica por patrón en J. Los resultados estéticos fueron muy buenos en 19 de 29 casos, buenos en 7 y mediocres en 4. En tres casos hemos corregido una asimetrÍa residual mediante simetrización contra lateral o con aumento por implantes de silicona. Con un seguimiento de más de 63 meses, la sobre vida global fue de 91%. No hubo márgenes comprometidos, recidivas locales ni contra laterales. En todos los casos las pacientes manifestaron estar satisfechas con sus resultados estéticos y funcionales. La plastia en J, por su practicidad constituye un elemento a tener en cuenta al momento de decisión en el arsenal quirúrgico para quienes se dediquen a la cirugía por esta enfermedad.

Surgical treatment is one of the pillars in the management of breast cancer. The indications for breast conserving surgery have grown with the advances in oncoplastic techniques, which allow the resection of greater volumes while maintaining or improving esthetic results. We present a description of and our experience with the J plasty, a versatile and reproducible technique for partial breast reconstructions, applicable for tumors in all quadrants. Twenty nine patients underwent breast conserving surgery (27 quadrantectomies, 2 lumpectomies), followed by repair with a J plasty. Esthetic results were good in 19 of the 29 cases, good in 7 and poor in 4. In 3 cases a resulting asymmetry was corrected either with a contralateral symmetrization or silicone implant augmentation. With a follow-up of over 63 months, overall survival was 91%. There were no positive margins, local or contralateral recurrences. All patients reported being satisfied with their esthetic and functional outcomes. The J plasty is a very practical technique and should be considered by all those performing surgery for this disease.

Cirugías de conversión en reconstrucción mamaria / Conversion surgery in breast reconstruction

La cirugía en cáncer de mama puede lograr un buen controllocal en condiciones estéticas aceptables. Estudios con másde 20 años de seguimiento demostraron la seguridad del tratamientoconservador y que la reconstrucción no tiene efectosdeletéreos sobre la evolución de la enfermedad. Debemos haceresfuerzos para lograr resultados cosméticos favorables, y cuandoestos son mediocres o se deterioran con el tiempo debemospoder corregirlos.Presentamos cuatro casos de reconstrucción post mastectomía.Fueron reconstrucciones por implantes con resultados estéticoscomplicados. Tres fueron reconstruidos en otros centros;uno de nuestra propia serie. Luego de una cuidadosa consideraciónde los antecedentes oncológicos y motivos del deterioroestético, realizamos una nueva reconstrucción usando tejidosautólogos para disminuir la probabilidad de futuras complicaciones.Introducimos el término cirugía de conversión para significarel cambio de un tipo de reconstrucción a otro.Los resultados de estas intervenciones fueros exitosos. Elseguimiento de 22 meses no mostró enfermedad recurrente, conresultados satisfactorios y aceptación de los pacientes.Para disminuir las complicaciones y malos resultados encirugías reconstructivas es importante el trabajo multidisciplinarioo una formación en la cirugía oncoplástica.La mastología incluye el control riguroso del cáncer, optimizandolos resultados estéticos con sus consecuencias psico-fisícas

Vólvulo de la vesícula biliar: presentación de un caso / Gallblader volvulus: case report

El vólvulo o torsión de vesícula biliar, si bien, es un cuadro poco frecuente, que afecta con mayor frecuencia a mujeres (3 a 1) entre los 65 y 75 años, constituye una de las causas de dolor abdominal a ser tenidas en cuenta en el diagnóstico diferencial del abdomen agudo del anciano. Se presenta el caso de una paciente de sexo femenino de 84 años, que ingresó al servicio por cuadro de dolor en FID de 24 horas de evolución, con náuseas y vómitos. El examen físico demostró dolor en FID, por lo que se decidió la cirugía con el diagnóstico de apendicitis aguda, constatándose en la misma un vólvulo de vesícula biliar, con áreas necróticas, realizándose una colecistectomía convencional. La paciente evolucionó satisfactoriamente.

Enfermedad de chagas en comunidades indídigenas del Chaco Paraguayo

Se determina la seroprevalencia de la enfermedad de chagas y la presencia de triatominos en la comunidad indigena de Somprero Piri, de la parcialidad Lengua-Mascoi, situada en zona del bajo Chaco Paraguayo. Para el mismo tomarón muestras de sangre a 146 personas. Se determino por análisis de las heces, la parasitación de los mismos por trypanosoma cruzi