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Increasing the solubility of drugs is a recurrent objective of pharmaceutical research, and one of the most widespread strategies today is the formulation of nanocrystals (NCs). Beyond the many advantages of formulating NCs, their incorporation into solid dosage forms remains a challenge that limits their use. In this work, we set out to load Atorvastatin NCs (ATV-NCs) in a delivery device by combining 3D scaffolds with an "in situ" loading method such as freeze-drying. When comparing two infill patterns for the scaffolds at two different percentages, the one with the highest NCs load was chosen (Gyroid 20 % infill pattern, 13.8 ± 0.5 mg). Colloidal stability studies of NCs suggest instability in acidic media, and therefore, the system is postulated for use as a sublingual device, potentially bypassing stomach and hepatic first-pass effects. An ad hoc dissolution device was developed to mimic the release of actives. The nanometric size and properties acquired in the process were maintained, mainly in the dissolution rate and speed, achieving 100 % dissolution of the content in 180 s. Based on these results, the proof of concept represents an innovative approach to converting NCs suspensions into solid dosage forms.

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Plants rely on complex regulatory mechanisms to ensure proper growth and development. As plants are sessile organisms, these mechanisms must be flexible enough to adapt to changes in the environment. GROWTH-REGULATING FACTORS (GRFs) are plant-specific transcription factors that act as a central hub controlling plant growth and development, which offer promising biotechnological applications to enhance plant performance. Here, we analyze the complex molecular mechanisms that regulate GRFs activity, and how their natural and synthetic variants can impact on plant growth and development. We describe the biological roles of the GRFs and examine how they regulate gene expression and contribute to the control of organ growth and plant responses to a changing environment. This review focuses on the premise that unlocking the full biotechnological potential of GRFs requires a thorough understanding of the various regulatory layers governing GRF activity, the functional divergence among GRF family members, and the gene networks that they regulate.

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Fossil discoveries can transform our understanding of plant diversification over time and space. Recently described fossils in many plant families have pushed their known records farther back in time, pointing to alternative scenarios for their origin and spread. Here, we describe two new Eocene fossil berries of the nightshade family (Solanaceae) from the Esmeraldas Formation in Colombia and the Green River Formation in Colorado (USA). The placement of the fossils was assessed using clustering and parsimony analyses based on 10 discrete and five continuous characters, which were also scored in 291 extant taxa. The Colombian fossil grouped with members of the tomatillo subtribe, and the Coloradan fossil aligned with the chili pepper tribe. Along with two previously reported early Eocene fossils from the tomatillo genus, these findings indicate that Solanaceae were distributed at least from southern South America to northwestern North America by the early Eocene. Together with two other recently discovered Eocene berries, these fossils demonstrate that the diverse berry clade and, in turn, the entire nightshade family, is much older and was much more widespread in the past than previously thought.

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Presentamos el caso de una paciente mujer de 31 años con antecedente de litiasis coraliforme bilateral. Ella inició la enfermedad un mes antes del ingreso con trombocitopenia y anemia hemolítica autoinmune. Fue diagnosticada con Síndrome de Evans, inicialmente tuvo marcadores de autoinmunidad negativos, finalmente presentó disnea progresiva y se le encontró 4 masas intracardiacas en aurícula derecha y marcadores positivos para síndrome antifosfolípido. A pesar de la anticoagulación y preparación para cirugía cardiaca, la paciente tuvo una muerte súbita.

We present the case of a 31-year-old female patient with a history of bilateral staghorn lithiasis, who started the disease one month before admission with thrombocytopenia and autoimmune hemolytic anemia. She was diagnosed with Evans Syndrome, initially she had negative autoimmunity markers, finally presented progressive dyspnea and 4 intracardiac masses were found in the right atrium and positive markers for antiphospholipid syndrome. Despite anticoagulation and preparation for cardiac surgery, she presented sudden death.

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A new optical method for assigning glass viscosity values in the softening temperature range is presented. In this method, an irregular particle, a few millimeters in size, laying on an alumina plate, is heated up to temperature T, and then remains at this temperature. T should be within the softening temperature range of the glass. There are no external applied shear stresses, the only acting shear forces are those coming from the particle's own surface energy. At the fixed temperature T, the surface free energy of the sample decreases by viscous flow while its shape evolves from a polyhedron or irregular shape towards a spherical or rounded shape. This shape evolution is recorded using a photographic camera. From each image, the sample's roundness is determined, obtaining a characteristic time τ from the roundness against time. Simultaneously, using the available software, a value for the viscosity η was calculated, at temperature T, allowing for building sets of T, τ, η, namely three data values. Accordingly, if T, τ are considered as independent variables, a master function η = η (T, τ) can be built. Now, if we measure T, τ data on a glass of an unknown viscosity, the master function makes it possible to assign a η value. When incipient crystallization or liquid-liquid phase separations are present, effective viscosity values are obtained. This method requires a high temperature microscope, as well as tridimmensional samples with a few cubic millimeters of volume. Each isothermal τ determination can take from minutes to several hours. We tested the method with two glasses of known viscosity values: borosilicate glass (VG98) and alumimoborosilicate glass (SG7), both of which are used for radioactive waste immobilization and have assigned log(η) values between 6 and 7.3 with η in Pa s. The discrepancy between the log(η) values assigned here and those values fitted with a VFT function on the values measured for the SG7 and VG98 glasses were within ±14%.

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BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities.OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques.METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities.RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36).CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.

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Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder characterized by headache, encephalopathy, seizures and visual disturbances, with reversible vasogenic edema in posterior brain areas. The aim of this research was to describe a case series of transplanted patients who developed PRES, characterize their presentation, treatment, clinical and imaging evolution. Electronic medical records were analyzed from January 2009 to January 2019. Demographic data, clinical backgrounds, causes of admission, hospital length of stay and time from transplantation to PRES were collected. Image improvement/resolution and annual survival were assessed. We identified 27 patients with PRES; 22 of 1647 total solid-organ transplant (1.3%) and 5 of 617 total bone marrow transplant (0.8%). The mean age at presentation was 38.2 years (SD 19.5), 62.9% female, 59.2% (16) before the year of transplantation. The most common comorbidities were kidney disease (14; 51%) and high blood pressure (11; 40%). Computed axial tomography (CT) was performed in 23 patients (85.1%), with pathological findings in 11 (47.8%). Magnetic resonance imaging (MRI) of 25 (92.6%), showed a characteristic pattern in 17 (62.9%) with improvement/resolution before the year in 20 (74%). Treatment was symptomatic, modifying immunosuppression. Five deaths were recorded during hospital stay and another 3 before the year of admission, with an annual survival of 70.3% (19 patients). Organ transplant trend is growing in our region. These patients are particularly susceptible to PRES, with a different imaging presentation and comorbidities from other populations.

El síndrome de leucoencefalopatía posterior reversible (PRES) es un desorden neurológico agudo caracterizado por cefalea, alteración de la conciencia, convulsiones y alteraciones visuales, con imágenes de edema vasogénico reversible en regiones cerebrales posteriores. Nos propusimos describir una serie de casos de pacientes trasplantados que desarrollaron PRES, caracterizando su presentación, evolución clínica, imágenes y terapéutica. Se analizaron historias clínicas informatizadas desde enero 2009 hasta enero 2019. Se recabaron datos demográficos, antecedentes clínicos, motivos y días de internación, tiempos desde el trasplante a la presentación clínica y diagnóstico. Se evaluó la mejoría/resolución en estudios por imágenes y la supervivencia anual. Se identificaron 27 pacientes con PRES; 22 trasplantados de órgano sólido de 1647 totales (1.3%) y 5 de médula ósea de 617 totales (0.8%). La media de edad fue de 38.2 años (DS 19.5), 62.9% de sexo femenino, 59.2% (16) antes del año del trasplante. Las comorbilidades más frecuentes enfermedad renal (14; 51%) e hipertensión arterial (11; 40%). Se realizó tomografía axial computarizada (TAC) a 23 pacientes (85.1%), siendo patológica en 11 (47.8%), y resonancia magnética nuclear (RMN) a 25 (92.6%), mostrando patrón característico en 17 (62.9%), con mejoría/resolución antes del año en 20 (74%). El tratamiento fue sintomático, modificando la inmunosupresión. Se registraron 5 óbitos durante la internación y otros 3 antes del año, con una supervivencia anual del 70.3% (19). La población de trasplantados, en crecimiento en nuestro medio, es particularmente susceptible al PRES. Tanto su presentación en estudios por imágenes, como su comorbilidad, difieren de otras poblaciones.

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Resumen El síndrome de leucoencefalopatía posterior reversible (PRES) es un desorden neurológico agudo caracterizado por cefalea, alteración de la conciencia, convulsiones y alteraciones visuales, con imágenes de edema vasogénico reversible en regiones cerebrales posteriores. Nos propusimos describir una serie de casos de pacientes trasplantados que desarrollaron PRES, caracterizando su presentación, evolución clínica, imágenes y terapéutica. Se analizaron historias clínicas informatizadas desde enero 2009 hasta enero 2019. Se recabaron datos demográficos, antecedentes clínicos, motivos y días de internación, tiempos desde el trasplante a la presentación clínica y diagnóstico. Se evaluó la mejoría/resolución en estudios por imágenes y la supervivencia anual. Se identificaron 27 pacientes con PRES; 22 trasplantados de órgano sólido de 1647 totales (1.3%) y 5 de médula ósea de 617 totales (0.8%). La media de edad fue de 38.2 años (DS 19.5), 62.9% de sexo femenino, 59.2% (16) antes del año del trasplante. Las comorbilidades más frecuentes enfermedad renal (14; 51%) e hipertensión arterial (11; 40%). Se realizó tomografía axial computarizada (TAC) a 23 pacientes (85.1%), siendo patológica en 11 (47.8%), y resonancia magnética nuclear (RMN) a 25 (92.6%), mostrando patrón característico en 17 (62.9%), con mejoría/resolución antes del año en 20 (74%). El tratamiento fue sintomático, modificando la inmunosupresión. Se registraron 5 óbitos durante la internación y otros 3 antes del año, con una supervivencia anual del 70.3% (19). La población de trasplantados, en crecimiento en nuestro medio, es particularmente susceptible al PRES. Tanto su presentación en estudios por imágenes, como su comorbilidad, difieren de otras poblaciones.

Abstract Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder characterized by headache, encephalopathy, seizures and visual disturbances, with reversible vasogenic edema in posterior brain areas. The aim of this research was to describe a case series of transplanted patients who developed PRES, characterize their presentation, treatment, clinical and imaging evolution. Electronic medi cal records were analyzed from January 2009 to January 2019. Demographic data, clinical backgrounds, causes of admission, hospital length of stay and time from transplantation to PRES were collected. Image improvement/ resolution and annual survival were assessed. We identified 27 patients with PRES; 22 of 1647 total solid-organ transplant (1.3%) and 5 of 617 total bone marrow transplant (0.8%). The mean age at presentation was 38.2 years (SD 19.5), 62.9% female, 59.2% (16) before the year of transplantation. The most common comorbidities were kidney disease (14; 51%) and high blood pressure (11; 40%). Computed axial tomography (CT) was per formed in 23 patients (85.1%), with pathological findings in 11 (47.8%). Magnetic resonance imaging (MRI) of 25 (92.6%), showed a characteristic pattern in 17 (62.9%) with improvement/resolution before the year in 20 (74%). Treatment was symptomatic, modifying immunosuppression. Five deaths were recorded during hospital stay and another 3 before the year of admission, with an annual survival of 70.3% (19 patients). Organ transplant trend is growing in our region. These patients are particularly susceptible to PRES, with a different imaging presentation and comorbidities from other populations.

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The objective of this study was to investigate the effects of a gel formulation from the association of Plectranthus neochilus and Cnidoscolus quercifolius on tissue repair in cutaneous wounds in rats. A surgical wound was induced in 35 Wistar rats and treated according to group: G1 - commercial phytotherapeutic gel; G2 - Carbopol gel 1%; G3, 4, 5 - gel formulation from Boldo-gambá and Favela (FGBF) at 2.5%, 5%, and 10%, respectively. 1ml of the product was applied topically daily, for 14 days. Macroscopic evaluation of the wound showed inflammation, granulation, and epithelization in all groups. The FGBF 2.5% group showed greater angiogenic potential. There was a significant difference between the surgical area of the wounds treated with FGBF 2.5%, 5%, or 10% compared to the group with the commercial phytotherapeutic gel. On histomorphometry of the skin, there were reepithelization of the epidermis and superficial dermis, longitudinal collagen fibers, fibroblasts, and blood vessels, and in the deeper dermis, fibroblasts, transverse and longitudinal collagen fibers, blood vessels, and inflammatory cells. The 2.5% formulation had the greatest increase in fibroblast proliferation and most intense collagenization on day 14 of treatment.(AU)

Este trabalho objetivou investigar os efeitos de uma formulação em gel da associação da Plectranthus neochilus e da Cnidoscolus quercifolius no processo de reparação tecidual em feridas cutâneas de ratos. Foi induzida uma ferida cirúrgica em 35 ratos Wistar, sendo tratadas de acordo com os grupos: G1 - fitoterápico comercial; G2 - gel de carbopol 1%; G3, G4 e G5 - formulação gel boldo-gambá mais favela (FGBF) 2,5%, 5% e 10%, respectivamente. Aplicou-se 1mL do produto, via tópica, diariamente, durante 14 dias. Na avaliação macroscópica das feridas, verificou-se inflamação, granulação e epitelização em todos os grupos. O grupo FGBF 2,5% apresentou maior potencial angiogênico. Houve diferença significativa entre as áreas cirúrgicas das feridas tratadas com os FGBF 2,5%, 5% ou 10%, comparados ao grupo com o gel fitoterápico comercial. Na histomorfometria da pele, observou-se reepitelização da epiderme e da derme superficial, fibras colágenas longitudinais, fibroblastos e vasos sanguíneos e, na derme profunda, fibroblastos, fibras colágenas transversais e longitudinais, vasos sanguíneos e células inflamatórias. A formulação a 2,5% teve o maior aumento na proliferação de fibroblastos e mais intensa colagenização no dia 14 de tratamento.(AU)

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INTRODUCTION: Approximately three billion people in Asia, Africa, and the Americas cook with biomass, cleaner cooking technologies with the potential to reduce household air pollution exposure. It is necessary to assess the adoption and long-term use of these stoves, measure perceived benefits among users, and use this information to provide feedback to programs that are implementing new cooking technologies. The aim of this study is to determine the level of adoption and impact of improved biomass cookstoves in the rural area of Lambayeque, Peru, in 2017. METHODS: A descriptive cross-sectional study was conducted. A total of 52 homes were surveyed in the districts of Pacora and Íllimo where improved biomass stoves were introduced between 2005 and 2013. A questionnaire for the assessment of adoption and impact indexes proposed by the Global Alliance for Clean Cookstoves was applied. The STROBE checklist was used. RESULTS: The mean number of years with the improved biomass cookstove was 9.1 (standard deviation: 2.9); 51.9% always used the improved stove, and 34.6% never used it due to destruction during the El Niño phenomenon in 2017. The median impact index was 5.62; 19.2% had a very good/good adoption. The median adoption index was 6.5; 25% had a very high/high impact. The use of the traditional or open fire biomass stove persisted in 61.5% of the houses. CONCLUSION: The adoption and impact of improved biomass cookstoves were acceptable, but traditional stove use persisted in more than half of the houses. Households used a mix of different stove technologies. Gas stoves were used more frequently for breakfast or dinner, while the traditional biomass stoves were used for larger lunchtime meals.

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Dogs have been implicated as main reservoirs for visceral leishmaniasis (VL) in urban areas. Therefore, studies on this species provide important data for public health. Thus, the objective of the present study was to ascertain the seroprevalence of canine VL (CVL) and the associated factors in the Brejo Paraibano microregion, northeastern Brazil. A total of 409 dogs were sampled from the eight municipalities of the microregion: Alagoa Grande, Alagoa Nova, Areia, Bananeiras, Borborema, Matinhas, Pilões and Serraria. The diagnosis of CVL was made using an enzyme-linked immunosorbent assay (ELISA S7®), through which the prevalence observed was 29.3%. By robust Poisson regression analysis two factors were associated with seroprevalence: illiterate/incomplete elementary owner's education level (prevalence ratio = 1.57; 95% CI = 1.05-2.34; p-value = 0.027) and tick infestation (prevalence ratio = 1.82; 95% CI = 1.27-2.61; p-value = 0.001). It is concluded that the seroprevalence of CVL in the Brejo Paraibano microregion is high. The factors associated with seroprevalence indicated the importance to develop socioeducational actions on the population, and the finding that tick infestation was associated with seroprevalence shows that there is a need for investigation regarding the role of ticks in the epidemiology of CVL.

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In this work, we report the synthesis of graft copolymers based on casein and N-isopropylacrylamide, which can self-assemble into biodegradable micelles of approximately 80 nm at physiological conditions. The obtained copolymers were degraded by trypsin, an enzyme that is overexpressed in several malignant tumors. Moreover, graft copolymers were able to load doxorubicin (Dox) by ionic interaction with the casein component. In vitro release experiments showed that the in situ assembled micelles can maintain the cargo at plasma conditions but release Dox immediately after their exposition at pH 5.0 and trypsin. Cellular uptake and cytotoxicity assays revealed the efficient delivery to the nucleus and antiproliferative efficacy of Dox in the breast cancer cell line MDA231. Both delivery and therapeutic activity were enhanced in presence of trypsin. Overall, the prepared micelles hold a great potential for their utilization as dual responsive trypsin/pH drug delivery system.

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O artigo resgata as perspectivas do brincar na teoria freudiana identificando dois modelos principais. O primeiro em que o brincar é compreendido a partir da teoria dos sonhos como realização de desejo, e o segundo, que surge em 1920, com o ensaio Além do princípio do prazer, quando ele é reposicionado ao lado dos sonhos traumáticos, das neuroses de guerra e da compulsão à repetição, às voltas com as questões do limite da representatividade e do colapso da temporalização da experiência. O fort-da inaugura, nesse contexto, uma perspectiva do brincar onde ele passa a ter uma função em si mesmo, quando apoia o sentido da experiência na materialidade, como ação disparadora do processo de simbolização.

The article rescues the prospects of playing in Freudian theory, identifying two main models. The first in which the game is based on the theory of the subjects as the realization of the desire, and the second, which appears in 1920, with the "Beyond the pleasure principle", when repositioned next to the traumatic dreams, neurosis of war and compulsion to repeat, dealing with the problems of the limit of representativeness and the collapse of the experience timing. Fort-da starts, in this context, a perspective of playing from which it begins to have a function in itself, at a time when it supports the sense of experience in materiality, as a triggering action to the symbolization process.

El artículo rescata las perspectivas del juego en la teoría freudiana, identificando dos modelos principales. El primero en el que se entiende el juego basado en la teoría de los sueños como realización de deseo, y el segundo, que aparece en 1920, con el ensayo "Más allá del principio del placer", cuando se repo-siciona junto a los sueños traumáticos, de las neurosis de guerra y la compulsión a repetir, lidiando con los problemas del límite de representatividad y el colapso de la temporalización de la experiencia. Fort-da inaugura, en este contexto, una perspectiva del juego donde este comienza a tener una función en sí mismo, en el momento en que apoya el sentido de la experiencia en la materialidad, como una acción desencadenante del proceso de simbolización.

L'article récupère les perspectives du jeu dans la théorie freudienne, identifiant deux modèles principaux. Le premier dans lequel on comprend le jeu comme l'accomplissement du désir, ayant pour base la théorie du rêve ; et le second, qui apparaît en 1920, dans l'essai « Au-delà du principe du plaisir ¼ , où il est repositionné à côté des rêves traumatisants, des névroses de la guerre et de la répétition, qui font face aux questions de la limite de représentativité et de l'effondrement du transitoire de l'expérience. Le fort-da inaugure, dans ce contexte, une perspective de jeu où il commence à avoir une fonction en soi, au moment où il soutient le sens de l'expérience dans la matérialité, comme une action qui déclenche le processus de symbolisation.

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Dogs have been implicated as main reservoirs for visceral leishmaniasis (VL) in urban areas. Therefore, studies on this species provide important data for public health. Thus, the objective of the present study was to ascertain the seroprevalence of canine VL (CVL) and the associated factors in the Brejo Paraibano microregion, northeastern Brazil. A total of 409 dogs were sampled from the eight municipalities of the microregion: Alagoa Grande, Alagoa Nova, Areia, Bananeiras, Borborema, Matinhas, Pilões and Serraria. The diagnosis of CVL was made using an enzyme-linked immunosorbent assay (ELISA S7®), through which the prevalence observed was 29.3%. By robust Poisson regression analysis two factors were associated with seroprevalence: illiterate/incomplete elementary owners education level (prevalence ratio = 1.57; 95% CI = 1.05–2.34; p-value = 0.027) and tick infestation (prevalence ratio = 1.82; 95% CI = 1.27–2.61; p-value = 0.001). It is concluded that the seroprevalence of CVL in the Brejo Paraibano microregion is high. The factors associated with seroprevalence indicated the importance to develop socioeducational actions on the population, and the finding that tick infestation was associated with seroprevalence shows that there is a need for investigation regarding the role of ticks in the epidemiology of CVL.(AU)

Os cães são apontados como principais reservatórios da leishmaniose visceral (LV) em áreas urbanas. Portanto, estudos com essa espécie fornecem dados importantes para a saúde pública. Assim, o objetivo do presente estudo foi determinar a soroprevalência da leishmaniose visceral canina (LVC) e os fatores associados na microrregião do Brejo Paraibano, Nordeste do Brasil. Foram amostrados 409 cães dos oito municípios da microrregião: Alagoa Grande, Alagoa Nova, Areia, Bananeiras, Borborema, Matinhas, Pilões e Serraria. O diagnóstico de LVC foi realizado com o ensaio imunoenzimático (kit ELISA S7®), no qual a prevalência observada foi de 29,3%. Pela análise de regressão de Poisson robusta, dois fatores foram associados à soroprevalência: proprietário analfabeto ou com ensino fundamental incompleto (razão de prevalência = 1,57; IC 95% = 1,05-2,34; p-valor = 0,027) e infestação de carrapatos (razão de prevalência = 1,82; IC 95% = 1,27-2,61; p-valor = 0,001). Conclui-se que a soroprevalência da LVC na microrregião Brejo Paraibano é alta. Os fatores associados à soroprevalência indicaram a importância do desenvolvimento de ações socioeducativas na população, e a associação da infestação de carrapatos com a soroprevalência mostra que há necessidade de investigação sobre o papel dos carrapatos na epidemiologia da LVC.(AU)

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Abstract Dogs have been implicated as main reservoirs for visceral leishmaniasis (VL) in urban areas. Therefore, studies on this species provide important data for public health. Thus, the objective of the present study was to ascertain the seroprevalence of canine VL (CVL) and the associated factors in the Brejo Paraibano microregion, northeastern Brazil. A total of 409 dogs were sampled from the eight municipalities of the microregion: Alagoa Grande, Alagoa Nova, Areia, Bananeiras, Borborema, Matinhas, Pilões and Serraria. The diagnosis of CVL was made using an enzyme-linked immunosorbent assay (ELISA S7®), through which the prevalence observed was 29.3%. By robust Poisson regression analysis two factors were associated with seroprevalence: illiterate/incomplete elementary owner's education level (prevalence ratio = 1.57; 95% CI = 1.05-2.34; p-value = 0.027) and tick infestation (prevalence ratio = 1.82; 95% CI = 1.27-2.61; p-value = 0.001). It is concluded that the seroprevalence of CVL in the Brejo Paraibano microregion is high. The factors associated with seroprevalence indicated the importance to develop socioeducational actions on the population, and the finding that tick infestation was associated with seroprevalence shows that there is a need for investigation regarding the role of ticks in the epidemiology of CVL.

Resumo Os cães são apontados como principais reservatórios da leishmaniose visceral (LV) em áreas urbanas. Portanto, estudos com essa espécie fornecem dados importantes para a saúde pública. Assim, o objetivo do presente estudo foi determinar a soroprevalência da leishmaniose visceral canina (LVC) e os fatores associados na microrregião do Brejo Paraibano, Nordeste do Brasil. Foram amostrados 409 cães dos oito municípios da microrregião: Alagoa Grande, Alagoa Nova, Areia, Bananeiras, Borborema, Matinhas, Pilões e Serraria. O diagnóstico de LVC foi realizado com o ensaio imunoenzimático (kit ELISA S7®), no qual a prevalência observada foi de 29,3%. Pela análise de regressão de Poisson robusta, dois fatores foram associados à soroprevalência: proprietário analfabeto ou com ensino fundamental incompleto (razão de prevalência = 1,57; IC 95% = 1,05-2,34; p-valor = 0,027) e infestação de carrapatos (razão de prevalência = 1,82; IC 95% = 1,27-2,61; p-valor = 0,001). Conclui-se que a soroprevalência da LVC na microrregião Brejo Paraibano é alta. Os fatores associados à soroprevalência indicaram a importância do desenvolvimento de ações socioeducativas na população, e a associação da infestação de carrapatos com a soroprevalência mostra que há necessidade de investigação sobre o papel dos carrapatos na epidemiologia da LVC.

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BACKGROUND: There are approximately 72,000 people living with HIV/AIDS (PLHIV) in Peru. Non-adherence to antiretroviral therapy (ART) is the most important factor for therapeutic failure and the development of resistance. Peru has achieved moderate progress in meeting the 90-90-90 targets, but only 60% of PLHIV receiving ART are virally suppressed. The purpose of this study was to understand ART adherence in the Peruvian context, including developing sociodemographic and clinical profiles, evaluating the clinical management strategies, and analyzing the relationships between the variables and adherence of PLHIV managed at a regional HIV clinic in Lambayeque Province (Northern Peru). METHODS: This was a cross-sectional study with 180 PLHIV adults, non-randomly but consecutively selected with self-reported ART compliance (78.2% of the eligible population). The PLHIV profile (PLHIV-Pro) and the Simplified Medication Adherence Questionnaire (SMAQ) were used to collect sociodemographic information, clinical variables, and data specific to ART adherence. Descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was performed with the Mann-Whitney test, Chi square test, and Yates correction. RESULTS: The 180 PLHIV sample included 78.9% men, 49.4% heterosexual, 45% with a detectable HIV-1 viral load less than 40 copies/ml, 58.3% not consistently adherent, and only 26.1% receiving Tenofovir + Lamivudine + Efavirenz. Risk factors significant for non-adherence included concurrent tuberculosis, discomfort with the ART regime, and previous pauses in ART. Multivariate analysis of nested models indicated having children is a protector factor for adherence. CONCLUSIONS: Self-reported adherence appeared to be low and the use of first-line therapy is not being prescribed homogeneously. Factors associated with nonadherence are both medical and behavioral, such as having tuberculosis, pausing ART, or experiencing discomfort with ART. The Peruvian government needs to update national technical standards, monitor medication availability, and provide education to health care professionals in alignment with evidence-based guidelines and international recommendations. Instruments to measure adherence need to be developed and evaluated for use in Latin America.

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Melioidosis is an emerging disease in the Americas. This paper reviews confirmed cases, the presence of Burkholderia pseudomallei and the organization of national surveillance policies for melioidosis in South America. Confirmed cases in humans have been reported from Ecuador, Venezuela, Colombia, Brazil, and Peru. The bacterium has been isolated from the environment in Brazil and Peru. The state of Ceará, northeastern region of Brazil, is the only place where specific public strategies and policies for melioidosis have been developed. We also discuss the urgent need for health authorities in South America to pay greater attention to this disease, which has the potential to have a high impact on public health, and the importance of developing coordinated strategies amongst countries in this region.

RESUMO

Melioidosis, a disease caused by the pathogen Burkholderia pseudomallei, is a significant underreported endemic disease found in tropical countries worldwide. Recent studies have demonstrated that human melioidosis cases have been increasingly recognized in the Americas. Therefore, the first Scientific Reunion of Melioidosis in the Americas was organized in Colombia, with the participation of health authorities of 11 Latin American countries and the United States. This report summarizes the topics reviewed during the meeting, including how to identify human infections and properly diagnose them, with the goal of increasing recognition of the disease in the Americas.

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