Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
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Las Leishmaniosis son un grupo de enfermedades causadas por parásitos protozoarios del género Leishmania. En 1912, la forma cutánea localizada mejor conocida como “úlcera de los chicleros”, fue descrita por el Dr. Harald Seidelin como un padecimiento dermatológico localizado en la oreja, que afectaba principalmente a los chicleros de la península de Yucatán (1). Posteriormente, Francisco Biagi, logró aislar y cultivar al agente etiológico denominándolo Leishmania tropica mexicana, e identificó y demostró que el mosquito llamado Phlebotomus flaviscentellatus es el vector transmisor de la enfermedad (2, 3). A 110 años de la publicación del Dr. Seidelin, los avances en el conocimiento de la enfermedad han incrementado

La vacunación permitió la mayor meta lograda por la medicina contra las enfermedades infecciosas en el siglo XX: La erradicación de la Viruela. Una lucha iniciada en China mil años antes con la "viruelización" y catapultada por Jenner en el siglo XVIII con la primera vacuna. Hoy, las vacunas de ARNm, la nueva esperanza contra la pandemia de Covid-19, independientemente de su seguridad y eficacia, son rechazadas por movimientos antivacunas que impulsan noticias falsas y promueven la ignorancia. En el contexto actual, ese objetivo alcanzado contra la Viruela sería una utopía.

Es para nosotras un honor compartirles esta breve semblanza de quien fue quizás nuestro más grande mentor y formador en este maravilloso mundo de la Microbiología y Parasitología. Y es evidente que, para todos nosotros, el Dr. Francisco Biagi Filizola es un ícono mexicano de la investigación y docencia, exitoso en muchos aspectos y orgullo de nuestra máxima casa de estudios, la Universidad Nacional Autónoma de México.

Introducción. Algunas especies de hongos presentes en el ambiente pueden llegar a tener serias implicaciones en la salud, principalmente en la de personas con sistema inmunológico comprometido. Se ha reportado que las micosis invasoras y las endémicas presentan variaciones temporales y geográficas y son influenciadas por cambios climáticos globales. Objetivo. Determinar la variabilidad espaciotemporal de géneros de hongos de importancia en salud pública presentes en el medio ambiente en una región del norte de México. Material y Métodos. Se realizaron muestreos de aire en 18 sitios de Durango y Coahuila en tres estaciones del año utilizando un impactor de una etapa y cajas Petri con agar dextrosa Sabouraud suplementadas con antibióticos. Los datos climatológicos se obtuvieron de la plataforma Giovanni de la NASA. Se empleó un modelo matemático para determinar los géneros predominantes y su importancia relativa. Resultados. Los hongos predominantes en Durango fueron Bipolaris, Cladosporium y A. fumigatus con un índice de importancia acumulada de 50%, mientras que en Coahuila fueron A. niger, A. fumigatus, Alternaria y Bipolaris. Los sitios en Coahuila registraron precipitación pluvial más frecuente en fechas cercanas a los muestreos, aunque en comparación con los de Durango el acumulado fue menor. La temperatura ambiente también influyó en el tipo de hongo encontrado. Conclusiones. La identificación de géneros fúngicos puede ser de utilidad a los profesionales de la salud para el diagnóstico y toma de decisiones relacionadas con enfermedades micóticas o alergias respiratorias al tener conocimiento específico de aquéllos que son predominantes en una región.

Introducción. Desde el 2015, se han reportado casos emergentes de leishmaniosis cutánea localizada (LCL) en Tinum, Yucatán. Sin embargo, no existen registros de flebotominos en el peridomicilio.Objetivo. Reportar la presencia de flebotominos antropofílicos en el peridomicilio de un caso de LCL en el municipio de Tinum, Yucatán, México.Materiales y Métodos. Se realizó la historia clínica de la paciente. El diagnóstico y la identificación de especie de Leishmania se determinaron mediante PCR-RFLP. Se colocaron dos trampas CDC en el peridomicilio.Resultados. La paciente era una mujer de 65 años con una úlcera en la pierna izquierda, que no realiza actividades selváticas de riesgo. Se identificó a Leishmania mexicana como agente causal. Se colectó a Bichromomyia olmeca olmeca, Lutzomyia cruciata y Lutzomyia longipalpis en el peridomicilio.Conclusión. Se presenta el primer registro de flebotominos en el ambiente peridoméstico en Yucatán, lo que sugiere el riesgo de transmisión peridoméstica. 

Introduction. Chagas’s disease a neglected and debilitating tropical illness, caused by Trypanosoma cruzi-infection, afflicts millions of people in most Latin-American countries. In the same region, frequent and severe viral infection cases have been reported due to SARS-CoV-2, the causative agent of  COVID-19, deemed as the worst global pandemic in the 21st century.Objective. To investigate the Chagas disease-COVID-19-relationship, and the comorbidity effect on chagasic patients living in communities where SARS-CoV-2 have circulated during the last two years causing severe cases and deaths.Material and methods. Randomly selected chagasic patients (N=50) from rural localities of western Venezuela, where COVID-19 has occurred, were evaluated in order to know whether they had suffered SARS-CoV-2- infection. COVID-infected chagasic patients were clinically compared with non-chagasic individuals (N=22) who had suffered the viruses in the same localities.Results. SARS-CoV-2-infection caused significantly less aggressive effects in chagasic patients than in non-chagasic patients, evidenced by the short-lasting scarce mild symptoms and the attenuated clinical profile (p<0.05), without further complications. Comparison revealed   COVID-19 detection in 10% of chagasic patients, showing all of them mild clinical pattern and few symptoms, while non-chagasic COVID-infected control individuals, showed 45% and 13% severe and fatal cases, respectively. Conclusion. Chagasic patients suffering from COVID-19 comorbidity seem to express a robust immune response (Th1/Th2/Th17), which associated with anti-T. cruzi-glycoproteins circulating antibodies, directed to certain SARS-CoV-2glycoproteins (membrane/spike), may induce a short lasting and milder clinical profile. More investigations in populations where Chagas disease is endemic, is recommended.  

Introduction: The first reported case of infection by the new coronavirus occurred in China, in December 2019. Due to the spread of the disease, changes in lifestyle occurred, which, associated with the period of uncertainty, generated impacts on the health of the population. Objective: To understand the implications of the COVID-19 pandemic on the mental and physical health of medical students at a university in Espírito Santo. Methods: Cross-sectional study from August 2020 to January 2021, with a quantitative and qualitative approach, with medical students enrolled in all periods. Data collection was carried out with an electronic questionnaire, encompassing sociodemographic, economic, individual, and family characteristics about the period prior to and during the pandemic. Excel 2020 and OPENEPI programs were used for analyses. The study was approved by the Human Research Ethics Committee, under number 4.224.502. Results: 779 students were evaluated, mostly females (61.6%), between 20 and 24 years old (64.0%), in the first two years of the course (46.5%), residing in urban areas (98.1%) with 1 to 3 people in their household (65.0%), and unemployed (93.2%). Sample characteristics during the pandemic: need to pause enrollment (3.9%), constant concern with the family (73.9%), difficulty in adapting to distance education (76.0%), continuous family life (84.5%), changes in sleep (54.9%), physical activity (60.3%), and weight (71.0%), participation in household chores (77.9%), psychological pressure (47.6%), food (69.6 %). The variables that underwent significant changes between the previous period and during the pandemic were lower income (p=0.005), increased use of medication (p=0.0009), and self-perceived stress level (p≤0.0000001). Regarding the development of pain during the pandemic period, the following had an impact: female (p≤0.0000001), second year of the course (p=0.001), constant concern for the family (p=0.000002), difficulty in adapting to distance education (p=0.002), changes in sleep (p=0.000003), physical activity (p=0.001), weight (p=0.00007), and diet (p=0.01). For the development of mental disorders during the pandemic, the most significant were gender (p=0.004), constant concern for the family (p=0.005), sleep (p=0.006), and diet (p=0.003). Conclusions: Changes in living standards resulting from the pandemic had a negative impact on physical and mental health, making it essential for educational institutions to provide student with health care actions.

Introduction: The insertion of the intrauterine device is an expected competence for the general practitioner. However, this method faces many barriers to be inserted in health centers such as the lack of professionals’ training and women’s fear of feeling pain. Objective: To evaluate the intensity of pain during the intrauterine device insertion procedure performed by general practitioners in health centers in the metropolitan region of João Pessoa and its association with sociodemographic factors, clinical aspects of women, and medical training. Methods: This is a cross-sectional and descriptive study, based on data collected from 16 health centers in the cities of Conde, Caaporã, João Pessoa, and Sapé (state of Paraíba, Brazil) from March to October 2019. Data collection was carried out by individual interview with a structured questionnaire and pain was rated by the Visual Analog Scale. Data were analyzed using Mann-Whitney Test and Pearson’s Chi-square Test. Results: The study included 139 women aged between 14 and 47 years, whose mean pain was 5.5 for those who were menstruating and 4.6 for those who were not. Mild pain was present in 20.1%; moderate pain, in 38%; and intense pain, in 31.7%. Hysterometry above 7cm, history of use of anti-inflammatory drugs during menstruation, and dysmenorrhea were more present in those who reported intense pain (p&lt;0.001). Regarding the qualification of the physician who inserts the intrauterine device, there was no statistical significance in the correlation of intense pain with being a resident (p=0.268), time since graduation (p=0.080), or technical difficulty encountered (p=0.065). Conclusions: Therefore, pain was mostly considered as moderate, and IUD insertion is a feasible offer and procedure to be taught and implemented in Primary Health Care.

Introduction: Suicide is one of the main preventable causes of death. The COVID-19 pandemic may contribute to reinforcing risk factors and suicidal ideation, due to the reduced capacity for emotional coping in the face of the global health crisis. At the same time, Primary Health Care (PHC) services were required to produce a rapid response to issues related to mental health. Objective: To reflect on risk factors and possible interventions to prevent suicide in primary health care in the context of the COVID-19 pandemic. Methods: This is an integrative review based on the performance of a critical analysis of the international literature on risk factors and suicide prevention in PHC during the new coronavirus pandemic. This review was carried out through a survey of evidence in the international literature by accessing the following scientific databases: Web of Science, Science Direct, and Scopus using the descriptors Suicide AND Prevention AND COVID-19 AND Primary Health Care. Scientific articles available from December 2019 to September 2020 and published in Portuguese, English and Spanish were included. Results: The corpus of analysis consisted of 15 articles, with a predominance of the description of risk factors, implementation and adaptation of specific intervention strategies mediated by resources of Information and Communication Technologies (TICs) to provide mental health care. Conclusions: Collaborative care practices guided by the essential attributes of PHC stood out as priority strategies to offer continuous and longitudinal health care in the context of the pandemic.

Introduction: Heart failure (HF) has an increasing prevalence in the world and there is already a greater proportion of patients with this disease in need of palliative care (PC) in relation to other pathologies, such as cancer. Despite this, there is an inequity in the provision and recognition of the need for PC in individuals with HF. The identification of the necessary competencies for the physician who will offer this care is essential for improving the care provided to these patients. Objective: To identify, through a literature review, the necessary competencies to primary care physicians to provide care to patients with heart failure. Methods: The acronym SPIDER was used to construct the question and, based on it, we sought to identify the necessary skills for primary health care physicians to work in PC in HF. The bases searched were PubMed, SciELO, Lilacs, and Medline, using descriptors and their registered variations, guided by the question. In the relevant primary studies identified by the search strategy, more eligible studies were also searched in their cited articles. Results: Of 127 identified studies, 8 were selected for data extraction and evaluated by the thematic synthesis methodology. The most prevalent competence in the selected studies was to offer PC to patients with advanced stage HF. Other competencies pointed out were coordinating care and offering multidisciplinary care to patients with HF. Conclusions: This review evidenced the knowledge and skills required in the training of the PHC physician to achieve the main competencies in the promotion of PC to patients with HF.