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BACKGROUND:Chagas disease has historically been linked to triatomines and rural areas. However, urban infestations by one of its vectors, Triatoma infestans, are increasingly being reported. Urbanization is reshaping vectorial transmission patterns of this disease, creating new collective health challenges. To provide evidence on the eco-epidemiological status of Chagas in the metropolitan region of San Juan, Argentina, this study integrates data collected on biomedical, epidemiological, socioenvironmental, and territorial factors. METHODS:We conducted a cross-sectional analysis of 432 urban houses for infestations by Triatoma infestans and infection of these vectors with Trypanosoma cruzi, complemented by environmental, sociodemographic, and human practices surveys. Additionally, we carried out information, education, and communication (IEC) activities to engage with and become acquainted with the community. The IEC activities included immersive virtual reality experiences, community dialogue, and educational games in public spaces. RESULTS:Our study revealed a house infestation prevalence with T. infestans of 10% both indoors and in the houses' outdoor spaces; T. cruzi infection was not detectable in any of the insects. Wind was identified as an environmental factor associated with house infestation, as was the presence of chicken coops, in addition to the condition of the houses (structural condition, such as cracks and poor plastering, and how the outdoor space of the houses was used, e.g., for the storage of objects that had accumulated over time). A combination of sociodemographic and environmental factors influenced T. infestans infestation prevalence. The IEC activities reached over 150 community members and promoted a dialogue about Chagas disease and vector control. The virtual reality and educational games encouraged strong youth engagement, and the media campaign helped raise awareness and visibility of the issue in the region. CONCLUSIONS:The infestation prevalence of T. infestans in the urban area of San Juan highlights the need for urban-specific control strategies that differ from those used in rural settings. The key findings of this study, such as chicken coops being infestation hotspots and the importance of wind direction, and the unique urban context (high-density housing, a territorial institutional presence, and community networks), enable us to recognize opportunities for integrated, multi-actor control frameworks that actively involve communities.
Determining the current advances in post-mastectomy breast reconstruction is a topic of great interest due to the connotations it carries with it. A structured review was carried out for the research; Two research questions were generated focused on the topic: What are the current advances in post-mastectomy breast reconstruction? What are the surgical techniques used for post-mastectomy breast reconstruction? Search terms consisted of mammoplasty, plastic surgery procedures, breast implants, breast neoplasms, breast diseases. The search in databases such as Pubmed, Mendeley, Wiley, Web of Science, Cochrane, Latindex and Google Scholar, with articles published in the last 5 years, and others of more than 5 years that provided relevant data. We chose observational, randomised studies, systematic reviews, case presentations related to the research topic to assess the number of available studies. The current management of breast cancer includes immediate breast reconstruction, which is performed after the initial mastectomy treatment, and breast reconstruction, by placing a prepectoral or subpectoral breast implant to the pectoralis major muscle or by using the patient's own tissue with autologous reconstruction, accompanied by immediate radiotherapy, constituting an advance whose results are still under discussion. Regarding post-mastectomy breast reconstruction, it is important to first determine if the patient with breast cancer is willing to undergo breast reconstructive treatment because this can influence the results. According to the data obtained, patients with autologous fat transfer obtained greater satisfaction, greater physical well-being and better results.
A dentigerous cyst associated with an ectopic third molar in the maxillary sinus is an extremely rare pathological entity that poses diagnostic and therapeutic challenges. We report the case of a 22-year-old woman with a four-month history of chronic nasal congestion and postnasal drip sensation, without a relevant medical history. Cone-beam computed tomography (CBCT) confirmed a cystic lesion associated with an ectopic third molar, allowing accurate three-dimensional assessment for surgical planning, with partial involvement of the left maxillary antrum. Given the size and location of the lesion, complete cystic capsule enucleation and ectopic tooth odontectomy were performed using the Caldwell-Luc approach under local anesthesia. Histopathological examination confirmed the diagnosis of a dentigerous cyst. Clinical and imaging follow-up at six months showed complete resolution of sinonasal symptoms and no evidence of recurrence. This case highlights that the Caldwell-Luc approach guided by CBCT remains a viable and effective option for treating extensive odontogenic cystic lesions involving the maxillary sinus.
Klebsiella pneumoniae is a Gram-negative bacterium that requires oxygen and is capable of fermenting lactose. It can cause serious infections such as pneumonia, bacteremia, and liver abscesses. There are two main subtypes: the classic strain (cKP) and the hypervirulent strain (hvKP), the latter being identified by its highly viscous mucus phenotype and its remarkable ability to invade.The most common hvKP lineage is ST23-K1, although K2 lineages (ST65, ST86, ST66) have also been recognized in different parts of the world, including South America. hvKP can affect healthy individuals and those with additional diseases, with diabetes mellitus being a relevant risk factor due to its association with immune dysfunction and hyperglycemia, conditions that favor bacterial growth and spread through the circulatory system. The case presented concerns a 45-year-old diabetic woman who was admitted with severe diabetic ketoacidosis and pneumonia caused by Klebsiella pneumoniae. Despite intensive treatment that included antibiotics and respiratory support, the patient developed multiple lung abscesses and a possible septic embolism, dying after 18 days in intensive care unit.
