A more radical perspective on surgical approach and outcomes in pancreatic cancer-a narrative review.

Background and Objective: Pancreatic adenocarcinoma remains a dismal disease and is expected to become an even greater burden in the near future. This review focuses on the different surgical aspects for pancreaticoduodenectomy (PD), distal and total pancreatectomy (TP), incorporating lessons from both the western and eastern visions in treating pancreatic cancer. Methods: We conducted an extensive literature review through PubMed, prioritizing papers published in the last 5 years, but older emblematic papers were also included. We included articles that explored the treatment of pancreatic adenocarcinoma, with focus on the surgical aspect and strategies to improve outcomes. References of selected articles were also reviewed to identify any missed studies. Only papers in English were included. Key Content and Findings: As evidence continues to build, it is clear that both systemic and surgical therapies have a fundamental and complementary role. State of art surgical treatment encompasses complete mesopancreas excision for radical lymphadenectomy. Preoperative planning of dissection planes, extensive knowledge of vascular anatomic variations, oncological principles and expertise for vascular resections are mandatory to perform a more radical operation, in pursuit of improved outcomes. Conclusions: Based on current data, patient selection remains key and a more radical surgical approach brings more accomplishing results bringing as to believe that more is better.

Metagenomic Insights for Antimicrobial Resistance Surveillance in Soils with Different Land Uses in Brazil.

Land-use conversion changes soil properties and their microbial communities, which, combined with the overuse of antibiotics in human and animal health, promotes the expansion of the soil resistome. In this context, we aimed to profile the resistome and the microbiota of soils under different land practices. We collected eight soil samples from different locations in the countryside of São Paulo (Brazil), assessed the community profiles based on 16S rRNA sequencing, and analyzed the soil metagenomes based on shotgun sequencing. We found differences in the communities' structures and their dynamics that were correlated with land practices, such as the dominance of Staphylococcus and Bacillus genera in agriculture fields. Additionally, we surveyed the abundance and diversity of antibiotic resistance genes (ARGs) and virulence factors (VFs) across studied soils, observing a higher presence and homogeneity of the vanRO gene in livestock soils. Moreover, three ß-lactamases were identified in orchard and urban square soils. Together, our findings reinforce the importance and urgency of AMR surveillance in the environment, especially in soils undergoing deep land-use transformations, providing an initial exploration under the One Health approach of environmental levels of resistance and profiling soil communities.

Quercetin-loaded chitosan nanoparticles as an alternative for controlling bacterial adhesion to urethral catheter.

OBJECTIVES: The present study aimed to assess the antimicrobial and antiadhesion behavior of quercetin-loaded chitosan nanoparticles in Escherichia coli and Staphylococcus aureus multidrug-resistant isolates. METHODS: The ionic gelation method was used to prepare chitosan nanoparticles loaded with quercetin. The antimicrobial and antibiofilm effects were observed by minimum inhibitory concentration (MIC), plate count, crystal violet assay, and the matrix exopolysaccharide dosages. The nanoparticles coated in silicone urethral catheters were evaluated by crystal violet assay and plating count method. RESULTS: MIC ranged from 6.25 to 12.5 mg/ml. A reduction of at least 3.6 log CFU/ml and 6.2 log CFU/ml for, respectively, E. coli and S. aureus isolates was observed (p < 0.05). Under subinhibitory concentration (3.1 mg/ml) it was found a reduction of microbial adhesion and exopolysaccharide dosages in respectively 83.3% and 75% of the bacterial samples. The coated silicone urethral catheters showed a reduction of adhered cells in 25% of the isolates and biomass decreasing in 91.6% of them (p < 0.05). CONCLUSIONS: The quercetin nanoparticles provided antimicrobial and antiadhesion effects in multidrug-resistant isolates.

Meaning of Breast Cancer in Women's Discourse / Significado del cáncer de mama en el discurso de las mujeres / Significado do câncer de mama no discurso das mulheres

Objective: To reveal the meaning of breast cancer. Materials and method: A narrative research study that selected, using the snowball technique, 11 women (data saturation) diagnosed with breast cancer, on disease remission, and living in the region of Florianópolis (Brazil). Semi-structured interviews were conducted between August and December 2018, and they were subjected to the Collective Subject Discourse technique. Four central ideas emerged from the analysis of the narratives; this article presents the central ideal called "Meaning of the breast cancer diagnosis", which has eight sense categories. Results: The central idea covers the following categories: "Suffering when facing the diagnosis", "Fear of the disease and of death", "Professional inability for bad news", "Initiatives to streamline treatment", "Concern and affection with the family members as a driving force to face cancer", "Difficulties with the family members", "Support from the family members, from the professionals and/or from the support group", and "Faith and spirituality". Conclusions: The discourse reveals that the meaning of the disease diagnosis is linked to the need for treatment, to the support provided by faith, family members, the health team, and support groups, and to the difficulties faced with family members and professionals. These results should imply the provision of specific Nursing care from the diagnostic phase until after cancer remission/survival.

Objetivo: revelar el significado del diagnóstico de cáncer de mama. Materiales y método: investigación narrativa, que seleccionó, desde la técnica bola de nieve, 11 mujeres (saturación de los datos), con diagnóstico de cáncer de mama, en remisión de la enfermedad, habitantes de Florianópolis (Brasil). Se aplicó la entrevista semiestructurada, entre agosto y diciembre del 2018, sometida a la técnica del discurso do sujeto colectivo. Del análisis de las narrativas, emergieron cuatro ideas centrales; en el artículo, se presenta la idea central "significado del diagnóstico del cáncer de mama", que cuenta con ocho categorías de sentido. Resultados: la idea central abarca las categorías "El sufrimiento ante el diagnóstico", "Miedo a la enfermedad y la muerte", "Inhabilidad profesional para las malas noticias", "Iniciativas para agilizar el tratamiento", "Preocupación y afecto con los familiares como resorte impulsador para enfrentarse al cáncer", "Dificultades con los familiares", "Apoyo de los familiares, de los profesionales y/o del grupo de apoyo" e "Fe y espiritualidad". Conclusiones: el discurso evidencia que el significado del diagnóstico de la enfermedad se vincula a la necesidad del tratamiento, al apoyo de la fe, de familiares, del equipo de salud y de grupos de apoyo, a las dificultades enfrentadas con familiares y profesionales. Estos resultados deben implicar la previsión de cuidados de enfermaría específicos desde la fase diagnóstica hasta después de la remisión/sobrevivencia del cáncer.

Objetivo: revelar o significado do diagnóstico de câncer de mama. Materiais e método: pesquisa narrativa, que selecionou, pela técnica bola de neve, 11 mulheres (saturação dos dados), com diagnóstico de câncer de mama, em remissão da doença, residentes na região de Florianópolis (Brasil). Aplicou-se entrevista semiestruturada, entre agosto e dezembro de 2018, submetida à técnica do discurso do sujeito coletivo. Da análise das narrativas, emergiram quatro ideias centrais; neste artigo, apresenta-se a ideia central "significado do diagnóstico de câncer de mama", que conta com oito categorias de sentido. Resultados: a ideia central abrange as categorias "O sofrimento diante do diagnóstico", "Medo da doença e da morte", "Inabilidade profissional para as más notícias", "Iniciativas para agilizar o tratamento", "Preocupação e afeto com os familiares como mola impulsionadora para o enfrentamento do câncer", "Dificuldades com os familiares", "Apoio dos familiares, dos profissionais e/ou do grupo de apoio" e "Fé e espiritualidade". Conclusões: o discurso revela que o significado do diagnóstico da doença vincula-se à necessidade do tratamento, ao apoio da fé, de familiares, da equipe de saúde e de grupos de apoio, às dificuldades enfrentadas com familiares e profissionais. Esses resultados devem implicar a previsão de cuidados de enfermagem específicos desde a fase diagnóstica até após a remissão/sobrevivência do câncer.

Unravelling the effects of the food components ascorbic acid and capsaicin as a novel anti-biofilm agent against Escherichia coli.

This study aimed to evaluate the influence of capsaicin and ascorbic acid on the physiology of biofilm formation and dispersion. The influence of the E. coli ATCC 25922 biofilm and five E. coli isolates were observed in the presence of sodium hypochlorite 2.5 mM and subinhibitory concentrations of capsaicin (7 mM) and ascorbic acid (100 mM). The cells counts were performed through standard plaque count and the architecture visualized by confocal microscopy. The proteins, carbohydrates, and DNA present in the biofilm matrix were also quantified. There was a reduction in adhered cells in the presence of capsaicin (7 mM) and ascorbic acid (100 mM) in the biofilm formation kinetics, however, regarding the dispersion, only capsaicin altered the biofilm, data confirmed by confocal fluorescence microscopy (p < 0.05). It was noted that the matrix composition is dynamic and may be affected by changes in growth conditions such as the presence of antimicrobial substances.

Comparative Study Of Genetic Diversity, Virulence Genotype, Biofilm Formation And Antimicrobial Resistance Of Uropathogenic Escherichia coli (UPEC) Isolated From Nosocomial And Community Acquired Urinary Tract Infections.

INTRODUCTION: Escherichia coli is a Gram-negative opportunistic human pathogen, which has aroused considerable medical interest for being involved in cases of urinary tract infection. AIM: Characterize the E. coli isolated both in the hospital and in the community. METHODOLOGY: A total of 200 E. coli isolated in urine samples from hospital and community were evaluated in biofilm formation assay and hydrophobicity MATS method. Antimicrobial susceptibility was performed through agar-diffusion technique. Virulence and ESBL production genes were observed through the polymerase chain reaction amplification of papC, fimH, fliC, kpsMTII, blaTEM, blaCTX-M, blaSHV , and blaOXA. The phylogenetic classification was based on the pattern chuA and yjaA and the region TspE4.C2 by PCR Multiplex. RESULTS: A higher frequency of non-adherent or poorly adherent isolates was observed in the community group. Approximately 85% of the community isolates were distributed in the highest hydrophilicity group (p<0.05). The level of resistant microorganisms was present at the same level in both source (p>0.05). About 14% of the hospital isolates were positive in the ESBL phenotypic detection test (p>0.05). Among the samples, 95% presented ESBL-encoding genes. The predominant phylogenetic group was B2 (78%). Community isolates showed a higher prevalence of virulence genes fimH, papC, and kpsMTII when compared to hospital samples. CONCLUSION: These data confirm the worldwide trend that isolates in the community present sometimes higher levels of virulence and antimicrobial resistance.

Antioxidant, mutagenic, and antimutagenic activity of frozen fruits.

Many studies have focused on the effect of fresh fruits on the risk of developing cancer and other diseases involved with reactive species and free radicals. The intake of frozen fruits has spread widely in the last years, but, until now, their biological activity is not completely known. In this study, 23 samples of frozen fruits were analyzed for their nutritional composition, total polyphenols, total carotenoids, and vitamin C content. Antioxidant, mutagenic, and antimutagenic effects were also evaluated. Antioxidant assays included 2,2-diphenyl-1-picrylhydrazyl radical (DPPH(.)) scavenging activity and determination of superoxide dismutase (SOD)- and catalase (CAT)-like activities. Mutagenic and antimutagenic evaluations were performed in eukaryotic cells of Saccharomyces cerevisiae yeast. Most samples (74%) showed antioxidant activity similar to vitamin C in the DPPH(.) assay, and this activity was positively correlated (r = 0.366; P