Scissor-assisted vs. conventional endoscopic submucosal dissection for colorectal lesions: Systematic review and meta-analysis.

OBJECTIVES: Colorectal endoscopic submucosal dissection (ESD) is a technically complex procedure. The scissor knife mechanism may potentially provide easier and safer colorectal ESD. The aim of this meta-analysis is to evaluate the efficacy and safety of scissor-assisted vs. conventional ESD for colorectal lesions. METHODS: A search strategy was conducted in MEDLINE, Embase, and Lilacs databases from January 1990 to November 2023 according to PRISMA guidelines. Fixed and random-effects models were used for statistical analysis. Heterogeneity was assessed using I2 test. Risk of bias was assessed using the ROBINS-I and RoB-2 tools. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS: A total of five studies (three retrospective and two randomized controlled trials, including a total of 1575 colorectal ESD) were selected. The intraoperative perforation rate was statistically lower (risk difference [RD] -0.02; 95% confidence interval [CI] -0.04 to -0.01; P = 0.001; I2 = 0%) and the self-completion rate was statistically higher (RD 0.14; 95% CI 0.06, 0.23; P = 0.0006; I2 = 0%) in the scissor-assisted group compared with the conventional ESD group. There was no statistical difference in R0 resection rate, en bloc resection rate, mean procedure time, or delayed bleeding rate between the groups. CONCLUSION: Scissor knife-assisted ESD is as effective as conventional knife-assisted ESD for colorectal lesions with lower intraoperative perforation rate and a higher self-completion rate.

Gamma Knife radiosurgery for the management of glomus jugulare tumors: A systematic review and report of the experience of a radioneurosurgery unit in Latin America.

Background: Glomus jugulare tumors (GJTs) are rare and mainly affect women between the 5th and 6th decades of life. Its localization and anatomic relationships make conventional surgical treatment difficult and with a considerable risk of complications. This manuscript aims to describe the results of Gamma Knife radiosurgery (GKR) in patients with GJT treated in a single center in Latin America, as well as to systematically review the literature to determine the clinical and radiological effectiveness of this technique. Methods: A search of information from January 1995 to June 2023 was performed. Twenty-two articles reporting 721 GJT patients treated with GKR were included in the study. Variables such as symptomatic control, control of tumor size, and complications were evaluated. These variables were described using measures of central tendency and proportions. For the institutional experience, 77 patients with GJT tumors were included in the study. Pre-treatment clinical variables and follow-up data were collected from medical charts and phone interviews. The Short Form-36 scale was applied to assess the quality of life. The data were analyzed using the statistical program STATA17.0. Results: A total of 721 patients were considered. The median of patients included in these studies was 18.5. The mean age was 58.4 years. The median of symptom control was 89%, and the median of imaging control was 95.7%. In our institution, 77 patients were included in the study. The mean age was 53.2 years. The median hospital stay was 4.92 hours. For the clinical follow-up, information on 47 patients was obtained. An improvement in pre-treatment symptoms was described in 58%, with general symptomatic control of 97%. The tumor-control rate was 95%, and there were statistically significant differences in six of the nine Short Form-36 scale domains. Conclusion: GKR is an effective, safe, and cost-effective technique that offers a high degree of symptomatic and tumor size control in patients with GJT.

Actual over 3-year survival after stereotactic body radiation therapy in patients with unresectable intrahepatic cholangiocarcinoma.

PURPOSE: As a non-invasive treatment, stereotactic body radiation therapy (SBRT) has been an emerging and effective option for patients with unresectable intrahepatic cholangiocarcinoma (ICC). The Cyber Knife has an SBRT system, which can realize real-time tracking of tumors during treatment. It can protect the surrounding normal liver tissue while the tumor gets the therapeutic dose. The purpose of this study was to evaluate the factors affecting the local control rate for patients after SBRT treatment, and to predict the factors affecting survival rates, then to report the 3-year actual survival rates after treatment and identify the influencing factors of 3-year survival rate. MATERIALS AND METHODS: We conducted a long-term follow-up of 43 patients with unresectable intrahepatic cholangiocarcinoma who underwent Cyber Knife in our hospital from January 2016 to December 2018. Regular medical check-ups were performed every 2-3 months after SBRT to evaluated the effect of treatment. RESULTS: The median follow-up time was 15 months (4-78 months), and the median progression-free survival (PFS) was 6 months (95% CI, 2.788-9.212) and the median overall survival (OS) was 12 months (95% CI, 3.434-20.566), respectively. Based on modified Response Evaluation and Criteria in Solid Tumor (mRECIST), response rate (RR) and disease control rate (DCR) of SBRT in unresectable ICC were 55.2% and 86%. The 1-, 2- and 3-years OS rate were 51.2%, 32.6% and 23.3%. Multivariate analysis based on competing risk survival analysis identified that patients with multiple nodules, large diameter, high level of CA199 and CEA, poor ECOG performance status had worse overall survival (p < 0.05). Patients who survived ≥3 years had significantly lower levels of CEA, CA199, smaller tumor diameters and lower number of lesions (p < 0.05). CONCLUSION: The SBRT might be a candidate option for patients who unable to perform surgery. The rate of 3-year survival after SBRT for unresectable ICC can be expected with 23.3%.

Resistance profile and biofilm production capacity of Staphylococcus spp. beef slaughterhouse isolates and their sensitivity to Rosmarinus officinalis essential oil.

Microorganisms can interfere with meat quality, being a public health problem. The aim of this study was to characterize the antimicrobial susceptibility profile of Staphylococcus spp. isolated from utensils of a bovine slaughterhouse and to evaluate the antibacterial and antibiofilm activity of the essential oil of Rosmarinus officinalis L. (rosemary). Samples of surfaces and utensils used during slaughter in the northwest of the state of Paraná, Brazil were collected. After isolation and differentiation of the isolates by the coagulase test, the antimicrobial susceptibility test, Staphylococcus aureus identification and mecA gene research were performed. The study for biofilm production was carried out by the method of adhesion in borosilicate tube and by adhesion in polystyrene plate. Subsequently, the inhibitory activity of the R. officinalis essential oil and its ability to inhibit biofilm were investigated. Twenty-two of the samples collected were identified as coagulase-negative Staphylococcus and five as coagulase-positive Staphylococcus. There was resistance to all antibiotics tested, with clindamycin (33.33%) and rifampicin (29.6%) showing the highest rate. None of the samples was confirmed as Staphylococcus aureus or for the presence of the mecA resistance gene. The essential oil inhibited the growth of 48% of the isolates at a concentration of 16,000 µg/mL. Of these isolates, 33% were positive for biofilm production and this biofilm was also inhibited by the essential oil. This work revealed that multidrug-resistant Staphylococcus and biofilm producers are present in the slaughter environment and are susceptible to the essential oil of R. officinalis.

MRI radiomics in the prediction of the volumetric response in meningiomas after gamma knife radiosurgery.

PURPOSE: This report presents the first investigation of the radiomics value in predicting the meningioma volumetric response to gamma knife radiosurgery (GKRS). METHODS: The retrospective study included 93 meningioma patients imaged by three Tesla MRI. Tumor morphology was quantified by calculating 337 shape, first- and second-order radiomic features from MRI obtained before GKRS. Analysis was performed on original 3D MR images and after their laplacian of gaussian (LoG), logarithm and exponential filtering. The prediction performance was evaluated by Pearson correlation, linear regression and ROC analysis, with meningioma volume change per month as the outcome. RESULTS: Sixty calculated features significantly correlated with the outcome. The feature selection based on LASSO and multivariate regression started from all available 337 radiomic and 12 non-radiomic features. It selected LoG-sigma-1-0-mm-3D_firstorder_InterquartileRange and logarithm_ngtdm_Busyness as the predictively most robust and non-redundant features. The radiomic score based on these two features produced an AUC = 0.81. Adding the non-radiomic karnofsky performance status (KPS) to the score has increased the AUC to 0.88. Low values of the radiomic score defined a homogeneous subgroup of 50 patients with consistent absence (0%) of tumor progression. CONCLUSION: This is the first report of a strong association between MRI radiomic features and volumetric meningioma response to radiosurgery. The clinical importance of the early and reliable prediction of meningioma responsiveness to radiosurgery is based on its potential to aid individualized therapy decision making.

Chromosome Painting in Gymnotus carapo "Catalão" (Gymnotiformes, Teleostei): Dynamics of Chromosomal Rearrangements in Cryptic Species.

The genus Gymnotus is a large monophyletic group of freshwater weakly-electric fishes, with wide distribution in Central and South America. It has 46 valid species divided into six subgenera (Gymnotus, Tijax, Tigre, Lamontianus, Tigrinus and Pantherus) with large chromosome plasticity and diploid numbers (2n) ranging from 34 to 54. Within this rich diversity, there is controversy about whether Gymnotus (Gymnotus) carapo species is a single widespread species or a complex of cryptic species. Cytogenetic studies show different diploid numbers for G. carapo species, ranging from 40 to 54 chromosomes with varied karyotypes found even between populations sharing the same 2n. Whole chromosome painting has been used in studies on fish species and recently has been used for tracking the chromosomal evolution of Gymnotus and assisting in its cytotaxonomy. Comparative genomic mapping using chromosome painting has shown more complex rearrangements in Gymnotus carapo than shown in previous studies by classical cytogenetics. These studies demonstrate that multiple chromosome pairs are involved in its chromosomal reorganization, suggesting the presence of a complex of cryptic species due to a post zygotic barrier. In the present study, metaphase chromosomes of G. carapo occidentalis "catalão" (GCC, 2n = 40, 30m/sm+10st/a) from the Catalão Lake, Amazonas, Brazil, were hybridized with whole chromosome probes derived from the chromosomes of G. carapo (GCA, 2n = 42, 30m/sm+12st/a). The results reveal chromosome rearrangements and a high number of repetitive DNA sites. Of the 12 pairs of G. carapo chromosomes that could be individually identified (GCA 1-3, 6, 7, 9, 14, 16 and 18-21), 8 pairs (GCA 1, 2, 6, 7, 9, 14, 20, 21) had homeology conserved in GCC. Of the GCA pairs that are grouped (GCA [4, 8], [5, 17], [10, 11] and [12, 13, 15]), most kept the number of signals in GCC (GCA [5, 17], [10, 11] and [12, 13, 15]). The remaining chromosomes are rearranged in the GCC karyotype. Analysis of both populations of the G. carapo cytotypes shows extensive karyotype reorganization. Along with previous studies, this suggests that the different cytotypes analyzed here may represent different species and supports the hypothesis that G. carapo is not a single widespread species, but a group of cryptic species.

Gamma knife radiosurgery in pituitary adenomas. A single-center experience / Radiocirugía gamma knife en adenomas hipofisarios: experiencia en un centro

Abstract Stereotactic radiosurgery with gamma knife (GKS) is a treatment option for persistent or recurrent pituitary adenoma. The aim of our study was to report Argentine experience in GKS, assessing the efficacy and safety in our patients with pituitary adenomas. We performed a retrospective analysis of patients with pituitary adenomas treated with GKS between 2002 and 2017 in a single institution. Patient characteristics, biochemical remission rate (for functioning tumors), tumor control rate and adverse effects with GKS were inves tigated. The study cohort comprised 99 patients with a mean follow-up of 63 months: 51 somatotropinomas, 28 non-functioning adenomas, 15 corticotropinomas, 2 prolactinomas and 3 mixed pituitary tumors. The mean radiation dose was 30.6Gy for corticotropinomas, 29.3Gy for somatotropinomas and 19.6Gy for non-secreting adenomas. Global tumor control rate was 94.2%. Biochemical remission rate was 55.9%, being higher in acromegaly than in Cushing's disease (OR4.7, 95%Ci 2.1-10.4, p<0.0001). The mean time to remission was 29.5 months (range: 6-156). Hypopituitarism occurred in 26% of patients and those with Cushing's disease were more prone to develop new hormone deficiency after GKS (OR 2.93, 95%Ci 1.2-7.2, p = 0.019). This study shows argentine experience with the use of GKS in patients with pituitary adenomas, with similar results to those reported by centers with large radiosurgical experience. We achieved biochemical remission in more than 50% of patients and global tumor control in most of them. Hypopituitarism was the most frequent adverse effect, while others were infrequent.

Resumen La radiocirugía gamma-knife (GKS) constituye una alternativa de tratamiento en adenomas hipofisarios persis tentes o recurrentes. El objetivo de nuestro trabajo fue comunicar la experiencia argentina con GKS, evaluando eficacia y seguridad en nuestros pacientes con adenomas hipofisarios. Realizamos un análisis retrospectivo de pacientes con adenomas hipofisarios tratados con GKS entre 2002 y 2017. Se investigaron: características basales, tasa de remisión bioquímica, tasa de control tumoral y efectos adversos del GKS. Estudiamos 99 pa cientes adultos con un seguimiento medio de 63 meses: 51 somatotropinomas, 28 adenomas no funcionantes, 15 corticotropinomas, 2 prolactinomas y 3 tumores mixtos. La do sis media de radiación fue 30.6 Gy para cortico tropinomas, 29.3 Gy para somatotropinomas y 19.6 Gy para adenomas no secretores. La tasa global de control tumoral fue 94.2%. La tasa de remisión bioquímica fue 55.9%, si endo mayor en acromegalia que en enfermedad de Cushing (OR4.7, 95% Ci 2.1-10.4, p < 0.0001). El tiempo medio hasta la remisión fue 29.5 meses (rango: 6-156). Se produjo hipopituitarismo en el 26% de los pacientes. Aquellos con enfermedad de Cushing fueron más propensos a desarrollar nuevas deficiencias hormonales después del GKS (OR2.93, 95% Ci 1.2-7.2, p = 0.019). Este trabajo muestra la experiencia argentina con GKS en pacientes con adenomas hipofisarios, con resultados similares a los reportados por centros con amplia experiencia radioquirúrgica. Logramos remisión bioquímica en más del 50% de los pacientes y control tumoral global en la mayoría de ellos. El hipopituitarismo fue el efecto adverso más frecuente, mientras que otros fueron infrecuentes.

Gamma knife radiosurgery in pituitary adenomas. A single-center experience.

Stereotactic radiosurgery with gamma knife (GKS) is a treatment option for persistent or recurrent pituitary adenoma. The aim of our study was to report Argentine experience in GKS, assessing the efficacy and safety in our patients with pituitary adenomas. We performed a retrospective analysis of patients with pituitary adenomas treated with GKS between 2002 and 2017 in a single institution. Patient characteristics, biochemical remission rate (for functioning tumors), tumor control rate and adverse effects with GKS were investigated. The study cohort comprised 99 patients with a mean follow-up of 63 months: 51 somatotropinomas, 28 non-functioning adenomas, 15 corticotropinomas, 2 prolactinomas and 3 mixed pituitary tumors. The mean radiation dose was 30.6Gy for corticotropinomas, 29.3Gy for somatotropinomas and 19.6Gy for non-secreting adenomas. Global tumor control rate was 94.2%. Biochemical remission rate was 55.9%, being higher in acromegaly than in Cushing's disease (OR4.7, 95%Ci 2.1-10.4, p <0.0001). The mean time to remission was 29.5 months (range: 6-156). Hypopituitarism occurred in 26% of patients and those with Cushing's disease were more prone to develop new hormone deficiency after GKS (OR 2.93, 95%Ci 1.2-7.2, p = 0.019). This study shows argentine experience with the use of GKS in patients with pituitary adenomas, with similar results to those reported by centers with large radiosurgical experience. We achieved biochemical remission in more than 50% of patients and global tumor control in most of them. Hypopituitarism was the most frequent adverse effect, while others were infrequent.

La radiocirugía gamma-knife (GKS) constituye una alternativa de tratamiento en adenomas hipofisarios persistentes o recurrentes. El objetivo de nuestro trabajo fue comunicar la experiencia argentina con GKS, evaluando eficacia y seguridad en nuestros pacientes con adenomas hipofisarios. Realizamos un análisis retrospectivo de pacientes con adenomas hipofisarios tratados con GKS entre 2002 y 2017. Se investigaron: características basales, tasa de remisión bioquímica, tasa de control tumoral y efectos adversos del GKS. Estudiamos 99 pacientes adultos con un seguimiento medio de 63 meses: 51 somatotropinomas, 28 adenomas no funcionantes, 15 corticotropinomas, 2 prolactinomas y 3 tumores mixtos. La do sis media de radiación fue 30.6 Gy para cortico-tropinomas, 29.3 Gy para somatotropinomas y 19.6 Gy para adenomas no secretores. La tasa global de control tumoral fue 94.2%. La tasa de remisión bioquímica fue 55.9%, si endo mayor en acromegalia que en enfermedad de Cushing (OR4.7, 95% Ci 2.1-10.4, p < 0.0001). El tiempo medio hasta la remisión fue 29.5 meses (rango: 6-156). Se produjo hipopituitarismo en el 26% de los pacientes. Aquellos con enfermedad de Cushing fueron más propensos a desarrollar nuevas deficiencias hormonales después del GKS (OR2.93, 95% Ci 1.2-7.2, p = 0.019). Este trabajo muestra la experiencia argentina con GKS en pacientes con adenomas hipofisarios, con resultados similares a los reportados por centros con amplia experiencia radioquirúrgica. Logramos remisión bioquímica en más del 50% de los pacientes y control tumoral global en la mayoría de ellos. El hipopituitarismo fue el efecto adverso más frecuente, mientras que otros fueron infrecuentes.

Gamma Knife radiosurgery - 12 years of experience in a high-complexity center of a middle-income country.

Background: Gamma Knife radiosurgery (GKR) is a technique that consists of the release of a high dose of ionizing radiation onto a therapeutic target, which has been previously delimited. This technique was described by Lars Leksell and Borje Larsson in 1951. In Colombia, there is only one GKR unit functioning machine nowadays. The objective of this study is to describe the institutional experience of a single institution with Gamma Knife Perfexion over 12 years. Methods: We conducted a retrospective observational study. A total of 1906 medical records, taken from the period between May 4, 2010, and May 4, 2022, were included in the study. Descriptive analysis was performed through STATA 17 as statistic tool. Measures of central tendency were calculated depending on the distribution of the continuous data and proportions were taken into account in the case of qualitative variables. Results: A total of 1906 procedures were performed. Patients from 1 year to 99 years old were treated, with a median age of 51 years. The most frequent diagnoses were meningioma (20.8%), arteriovenous malformation (AVM) (17%), vestibular schwannoma (15.6%), metastases (9.81%), and trigeminal neuralgia (9.12%). At 3-year posttreatment, in meningiomas, tumor size stability was observed in 57.3%, size decrease in 36%, and disappearance in 1.3%. In AVM, complete obliteration of the lesion was described in 36.8% and a decrease in size in 52.6%. Intracranial hemorrhage occurred in 5.2% during the follow-up period and 3.5% of all treated patients required a new procedure due to residual malformation. In vestibular schwannomas, tumor size remained stable in 62.2% and decreased in 28.8%. No new cases of facial paralysis after the procedure were described. At 1-year posttreatment, in metastasis, the size of the lesions remained stable in 40% of the patients, decreased in 47.5%, and disappeared in 2.5%. In trigeminal neuralgia, 88.4% of patients had pain relief and recurrences occurred in 16.6%. Acute complications were generally uncommon, the main ones being headache, pain at frame fixation points, and nausea. Conclusion: Our experience suggests that GKR is a noninvasive procedure with a broad spectrum of clinical applications, low frequency of complications, feasible, with good enough control size of tumor and vascular lesions in images, and good clinical results in the medium and long term.

Synergistic and Antibiofilm Effects of the Essential Oil from Croton conduplicatus (Euphorbiaceae) against Methicillin-Resistant Staphylococcus aureus.

Bacterial resistance refers to the ability of bacteria to resist the action of some antibiotics due to the development of adaptation and resistance mechanisms. It is a serious public health problem, especially for diseases caused by opportunistic bacteria. In this context, the search for new drugs, used alone or in combination, appears as an alternative for the treatment of microbial infections, and natural products, such as essential oils, are important in this process due to their structural diversity, which increases the probability for antimicrobial action. The objective of this study was to extract and identify the chemical components of the essential oil from Croton conduplicatus (EOCC), to evaluate the antimicrobial activity, to investigate the effect of the interaction between the EOCC and different antibiotics and to evaluate its antibiofilm potential. The EOCC was obtained by hydrodistillation. Based on chemical characterisation, 70 compounds were identified, with 1.8 cineole (13.15%), p-cymene (10.68%), caryophyllene (9.73%) and spathulenol (6.36%) being the major constituents. The minimum inhibitory concentration (MIC) values of EOCC were 256 and 512 µg mL-1 for methicillin-sensitive and -resistant Staphylococcus aureus strains (MSSA and MRSA), respectively. The combinations of EOCC with the antibiotics oxacillin and ampicillin were synergistic (OXA/EOCC and AMP/EOCC combined decreased the OXA MIC and AMP MIC to 0.5 and 0.25 for MSSA, respectively, and OXA/EOCC and AMP/EOCC combined decreased the OXA MIC and the AMP MIC to 1 and 0.5 for MRSA, respectively) and could modify the resistance profile of MSSA and MRSA strains. The results indicated that EOCC was also able to partially inhibit biofilm formation. Our study presents important information about the chemical composition of EOCC and its antimicrobial potential and provides a reference to determine the mechanisms of action of EOCC and its use in pharmaceutical formulations.

Neoplasia intraepitelial escamosa cervical de alto grau: abordagem ambulatorial / High-grade cervical intraepithelial neoplasia: outpatient approach

As neoplasias intraepiteliais cervicais correspondem a alterações identificadas por rastreamento citológico cervical e estudo histológico, pós-biópsia incisional guiada por colposcopia ou procedimento diagnóstico excisional. Podem ser tratadas com abordagens conservadoras e procedimentos excisionais. A vacinação anti-HPV e o tratamento excisional oportuno constituem, respectivamente, prevenção primária e secundária contra o câncer do colo uterino.(AU)

Cervical intraephitelial neoplasms correspond to changes identified by cervical citological screening and histological study, post-incisional biopsy guided by colposcopy or excisional diagnostic procedure. They can be treated with conservative approaches and excision procedures. Anti-HPV vaccination and timely excional treatment are primary and secondary prevention against cervical cancer, respectively.(AU)

Humberto Fernández-Morán (1924-1999) a pioneer in electron ultra-cryomicroscopy / Humberto Fernández-Morán (1924-1999) pionero en ultracriomicroscopía electrónica

SUMMARY: Humberto Fernández-Morán (1924-1999) a Venezuelan physician and biophysicist research, who developed the diamond knife. Furthermore he focused on improving the mechanical performance, accuracy and reliability of mocrotomes and ultramicrotomes which significantly advanced the development of electromagnetic lenses for electron microscopy based on superconducting technology. Promoter and founded of the Venezuelan Institute for Neurological and Brain Studies. He was a pioneer in electron ultra-cryomicroscopy field. Fernández-Morán taught and researched in University of Stockholm, Massachusetts Institute of Technology, Harvard University, Massachussetts General Hospital and the University of Chicago. He worked with NASA for the Apollo project in the field of physic-chemical analysis of lunar rocks.

RESUMEN: Humberto Fernández-Morán (1924-1999) médico venezolano e investigador biofísico, quien desarrolló el cuchillo de diamante. Además, se centró en mejorar el rendimiento mecánico, la precisión y la fiabilidad de los micrótomos y ultramicrótomos, lo que avanzó significativamente en el desarrollo de lentes electromagnéticos para microscopía electrónica basados en tecnología superconductora. Promotor y fundador del Instituto Venezolano de Estudios Neurológicos y Cerebrales. Fue pionero en el campo de la ultracriomicroscopía electrónica. Fernández-Morán enseñó e investigó en la Universidad de Estocolmo, el Instituto Tecnológico de Massachusetts, la Universidad de Harvard, el Hospital General de Massachussets y la Universidad de Chicago. Trabajó con la NASA para el proyecto Apollo en el campo del análisis físico-químico de rocas lunares.

Presence of Listeria monocytogenes in Ready-to-Eat Meat Products Sold at Retail Stores in Costa Rica and Analysis of Contributing Factors.

ABSTRACT: Listeria monocytogenes is a pathogenic bacterium associated with ready-to-eat (RTE) meat products sold at the retail level. The objective of this research was to determine the prevalence of L. monocytogenes in RTE meat products sold at retail in Costa Rica and to study the factors associated with the levels of contamination; analyzed factors include hygienic practices within stores (cutting techniques and microbial contamination of products) and the behavior of the isolates (persistence against antimicrobials and transfer potential). A total of 190 samples of RTE meat products were collected and analyzed for the presence of coliforms and Listeria spp. Isolates of L. monocytogenes were then evaluated in terms of resistance to disinfectants (quaternary ammonium compound [QAC] and chlorine) and their transfer potential from food contact surfaces (knife and cutting boards). Overall Listeria spp. prevalence was 37.4% (71 of 190); Listeria innocua was present in 32.1% (61 of 190) of the products, and L. monocytogenes was found in just 2.6% (5 of 190) of the samples. Most contaminated samples were cut with a knife at the moment of purchase (44.2%). When analyzing practices within the stores, it was observed that L. monocytogenes transfer from inoculated knife to salchichón was higher for samples cut at the beginning of the experiment. In addition, L. monocytogenes transfer from inoculated cutting boards was independent of the number of slices but contamination from plastic was higher than wood. Regarding L. monocytogenes resistance to disinfectants, average reductions of 2.6 ± 1.1 log CFU/mL were detected after 6 min of exposure to 200 ppm of chlorine; however, chlorine resistance varied among the strains. Prevalence of L. monocytogenes in RTE meat products sold at retail could be associated with handling practices within the stores; further studies are necessary to estimate the impact of these practices on the overall risk for consumers.

Cutting force measurement: Hand tool instrumentation used in slaughterhouses - a systematic review.

Workers' intensive use of hand tool cutting in the meat packing industry is a risk factor for occupational health, mainly by mechanical compression of tissues in the upper limbs, which can cause Work-Related Musculoskeletal Disorders (WMSDs). This systematic review aimed to identify the characteristics and measured variables of instrumented knives and determine how they should be designed. The review process and article extractions occurred through an analysis of the (article) titles, keywords and abstracts, followed by reading the full texts by two reviewers independently. Searches were conducted in Medline, Web of Science, Science Direct, Scopus, Ebsco and Engineering Village for articles published in peer-reviewed journals from January 2000 to March 2019, in the English language. The result of (the) search included 1289 potentially eligible studies, with 894 duplicated/triplicated/quadruplicated articles that were excluded, resulting in 404 remaining articles of which 33 were considered eligible, with 36 additional articles, totaling 69 evaluated full texts. After the review, none of the 14 analyzed studies, were rated as having good methodological quality. In addition, four types of instrumented knives were used. Data acquisition was performed in both laboratory and meat processing plants. It is noteworthy that only one knife was submitted to a validation process and that the articles did not provide complete technical information about the knives. The result demonstrated that the cutting force varies within and between subjects, tasks, plants and blade finishings. All knives used some type of electrical connection via cable or wires. Of the articles found, none considered the influences that the workers are subject to when they do not use the same tool daily for data acquisition. Therefore, the development of different types of instrumented knives, with wireless data transmission and more rigorous studies are necessary to expand the knowledge of the cutting force and development of WMSD in slaughterhouse workers who perform meat cutting.

Caso raro: trauma penetrante craneoencefálico por un cuchillo. Actualización del diagnóstico y tratamiento / Rare case: penetrating head trauma by a knife. Diagnosis and treatment update

El trauma penetrante craneoencefálico representa alrededor del 0.4% de los casos, pocos son los descritos en la literatura, por lo cual, no existe un manejo protocolizado del mismo.Describimos un caso de un paciente masculino de 24 años que sufre un trauma penetrante a nivel de región parietal izquierda con arma blanca "cuchillo", dejando incrustada la hoja del mismo. La Tomografía computarizada simple de cráneo con reconstrucción en 3 dimensiones más angiografía, confirma el diagnóstico y descarta el compromiso vascular. Se realiza la extirpación completa del cuerpo extraño, sin complicaciones. Evolución favorable con mejoría de la sintomatología neurológica al alta.Este tipo de trauma es una emergencia que puede poner en riesgo la vida del paciente dependiendo del área afectada. La extirpación del cuerpo extraño debe realizarse en un medio hospitalario por la afectación de grandes vasos. Se debe tener una alta sospecha diagnóstica asociada al antecedente.

Craneoencephalic penetrating trauma represents about 0.4% of cases, few are described in the literature, therefore, there is no protocolized management of them.We describe a case of a 24-year-old male patient who suffers penetrating trauma at left parietal region with a "knife", leaving the blade embedded. Simple Computed Tomography of the Skull with Reconstruction in 3 dimensions plus angiography, confirms the diagnosis without vascular compromise. The complete removal of the foreign body was performed, without complications. Evolution is favorable and was discharged with improvement neurological symptoms.This type of trauma is an emergency that can put the life at risk depending on the affected area. The removal of the foreign body must be performed in a hospital environment due to the involvement of large vessels. There must be a high diagnostic suspicion associated with the antecedent.

Células glandulares atípicas: abordagem ginecológica / Atypical glandular cells: gynecological approach

As células glandulares atípicas representam 0,2% a 2,1% dos resultados dos testes de Papanicolaou. Mesmo com essa baixa prevalência, tem um significado importante no diagnóstico do câncer cervical e endometrial, tendo em vista que tais células e subcategorias, associadas à idade da paciente, podem prenunciar um número expressivo de doença intraepitelial, doença invasiva do endocérvix, endométrio e até neoplasias anexiais. E não se pode esquecer do importante número de resultados histológicos benignos, identificados no seguimento dessas pacientes, muitas vezes assintomáticas.(AU)

Atypical glandular cells represent 0,2% to 2,1% of Pap test results even with this low prevalence has an important significance in the diagnosis of cervical and endometrial cancer, considering that such cells and subcategories associated with the patient's age can predict a significant number of intraepithelial disease, invasive disease of the endometrium, endocervix and even adnexial neoplasms; no forgetting the important number of benign histological results, identified in the follow up of these patients, often asymptomatic.(AU)

Comparación dosimétrica en radiocirugía intracraneal entre Cyberknife y un bisturí de rayos gamma y su puesta en marcha Centroamérica / Dosimetric comparison in intracranial radiosurgery between Cyberknife and a gamma knife and its implementation Central America

Introducción: La dupla Cyberknife y bisturí de rayos gamma (Infini) que se describe es la primera en Latinoamérica. Ambas máquinas han mostrado ser los mejores equipos para radiocirugía intracraneal. Se describe la experiencia inicial de Cyberknife en Centroamérica y su incorporación a un programa existente de bisturí de rayos gamma por vía de análisis comparativos dosimétricos. Material y método: En el año 2019 se realizaron planes comparativos y se trataron 180 pacientes con radiocirugía intracraneal con ambos sistemas tanto en patología tumoral, como vascular y funcional. Resultados: En el análisis dosimétrico comparativo en el gradiente de dosis de Infini mostró ser superior a Cyberknife en todos los casos. Para una esfera utilizando el colimador de 4 mm en Infini y de 5 mm en Cyberknife utilizando un plan isocéntrico con el -Trigeminal Path- el gradiente de dosis para Infini fue de 1.5 y para Cyberknife de 1.66. Para los casos de patología el gradiente de dosis media para Infini fue de 3 mm y para Cyberknife de 3.8 mm. Dando un puntaje de gradiente de dosis (Gradient Score Index) si Infini fuese de 100, Cyberknife obtuvo 87.3. Cyberknife mostró mejor conformalidad y cobertura (97% versus 96%) para todos los targets. Entre enero 2019 y enero 2020 se realizaron 180 radiocirugías, 60 con Cyberknife y 120 con Infini, 60 pacientes recibieron 146 sesiones con Cyberknife, radiocirugía fraccionada 39 (65%) y 21 (35%) en sesión única. Las dosis medias en tumores en dosis única fue 15 Gy (12.5 a 25 Gy) y en radiocirugía fraccionada 21 Gy (18 y 35). Ningún paciente ha experimentado toxicidad mayor a grado dos. Conclusiones: El bisturí de rayos gamma rotatorio reveló superioridad en gradiente de dosis con relación al Cyberknife. En su primer año Cyberknife ha mostrado ser una herramienta segura en el tratamiento de patología intracraneal. Más seguimiento clínico y radiológico es necesario para verificar su efectividad comparativa

Introduction: The match between Cyberknife and Infini here described in this article is the first in Latinamerica. Both machines have proven to be the best for intracranial radiosurgery, we describe our initial experience with Cyberknife in Central America and how it was incorporated in an existing gamma ray program by ways of dosimetry comparisons. Methods: During 2019 comparative plans were made and a total of 180 patients received intracranial radiosurgery with both technologies, patients were treated for tumors, vascular anomalies, and functional pathology. Results: Basic dosimetry analysis regarding dose gradient the Infini proved superior to Cyberknife in all plans. For a sphere using the 4 mm collimator in Infini and the 5 mm in Cyberknife along with an isocentric plan using the -Trigeminal Path- dose gradient was 1.5 for Infini and 1.66 for Cyberknife. For the pathology cases Infini was 3 mm and for Cyberknife 3.8 mm on mean. Giving a Gradient Score Index (GSI) if Infini would be 100, Cyberknife would be 87.3. Cyberknife showed better conformality and coverage for all pathology targets (97% versus 96%). From January 2019 to January 2020, 180 intracranial radiosurgeries were done, 60 with Cyberknife and 120 with Infini, 60 patients received 146 sessions with Cyberknife, fractionated scheme 39 (65%) and 21 (35%) single dose. The median dose for tumors was 15 Gy (12.5 a 25 Gy) for single session and 21 Gy (18 y 35) for fractionated scheme. No patient experienced a higher toxicity tan grade two. Conclusions: In its first year Cyberknife has shown to be safe in treating intracranial pathology. Infini had a better dose gradient than Cyberknife. Longer clinical and radiological follow-up is needed to verify its comparative effectiveness.

Behavior and reproduction of belida fish (Notopterus notopterus, Pallas1769) in different stocking density and nurtured with different types offeed

Belida fish (Notopterus notopterus, Pallas 1769) is one of Indonesia's endemic fish that has high economic value so that the catch is so high and has begun to decline in population from nature. The purpose of this study was to analyze the behavior and reproduction of belida fish that nurtured with stocking density and different types of feed. This study was conducted from April to June 2018 in the Fish hatchery and Breeding Laboratory of Fisheries and Marine Science Faculty, Riau University. The design used is a randomized complete design with stocking density treatment consisting of 5, 10, and 15 tail/m³ and type of feed consisting of pellet + vitamin E feed and trash fish feed (dumbo catfish cubs). The results showed that the best treatment was in the stocking density of 5 tail/m³ and trash fish feed (dumbo catfish cubs) showed aggressive fish behavior in chasing the feed given, resulting in reproductive value consisting of the fish number of gonad maturity (TKG IV) as many as 5 fishes, gonado somatic index value of 0.58%, the fecundity of 6,053 eggs, egg diameter of 2.49 mm and semen volume of 0.045ml.(AU)

Behavior and reproduction of belida fish (Notopterus notopterus, Pallas1769) in different stocking density and nurtured with different types offeed

Belida fish (Notopterus notopterus, Pallas 1769) is one of Indonesia's endemic fish that has high economic value so that the catch is so high and has begun to decline in population from nature. The purpose of this study was to analyze the behavior and reproduction of belida fish that nurtured with stocking density and different types of feed. This study was conducted from April to June 2018 in the Fish hatchery and Breeding Laboratory of Fisheries and Marine Science Faculty, Riau University. The design used is a randomized complete design with stocking density treatment consisting of 5, 10, and 15 tail/m³ and type of feed consisting of pellet + vitamin E feed and trash fish feed (dumbo catfish cubs). The results showed that the best treatment was in the stocking density of 5 tail/m³ and trash fish feed (dumbo catfish cubs) showed aggressive fish behavior in chasing the feed given, resulting in reproductive value consisting of the fish number of gonad maturity (TKG IV) as many as 5 fishes, gonado somatic index value of 0.58%, the fecundity of 6,053 eggs, egg diameter of 2.49 mm and semen volume of 0.045ml.