Towards a species-level phylogeny for Neotropical Myrtaceae: Notes on topology and resources for future studies.

PREMISE: Increasingly complete phylogenies underpin studies in systematics, ecology, and evolution. Myrteae (Myrtaceae), with ~2700 species, is a key component of the exceptionally diverse Neotropical flora, but given its complicated taxonomy, automated assembling of molecular supermatrices from public databases often lead to unreliable topologies due to poor species identification. METHODS: Here, we build a taxonomically verified molecular supermatrix of Neotropical Myrteae by assembling 3909 published and 1004 unpublished sequences from two nuclear and seven plastid molecular markers. We infer a time-calibrated phylogenetic tree that covers 712 species of Myrteae (~28% of the total diversity in the clade) and evaluate geographic and taxonomic gaps in sampling. RESULTS: The tree inferred from the fully concatenated matrix mostly reflects the topology of the plastid data set and there is a moderate to strong incongruence between trees inferred from nuclear and plastid partitions. Large, species-rich genera are still the poorest sampled within the group. Eastern South America is the best-represented area in proportion to its species diversity, while Western Amazon, Mesoamerica, and the Caribbean are the least represented. CONCLUSIONS: We provide a time-calibrated tree that can be more reliably used to address finer-scale eco-evolutionary questions that involve this group in the Neotropics. Gaps to be filled by future studies include improving representation of taxa and areas that remain poorly sampled, investigating causes of conflict between nuclear and plastid partitions, and the role of hybridization and incomplete lineage sorting in relationships that are poorly supported.

Climatic niche shift after range expansion of Eustachys (Poaceae).

Eustachys presents lower diversity in the Old World than in the Neotropics and it occurs disjunctly between main tropical regions. This qualifies Eustachys as a good model to test whether lineages expand their niches during the process of range expansion. We performed ancestral range reconstruction, compared environmental spaces of the different geographic areas and assessed bioclimatic trait evolution. Ancestral range reconstruction indicated that most speciation in Eustachys occurred in the South America. Ancestral climatic niches of the New World are different from those of African and Australasia lineages. Our results show that Eustachys experienced niche expansion when it reached the New World. Evolutionary history of Eustachys illustrates how the range expansion promoted climatic niche shifts, which could drive unbalanced species richness of the genus among different tropical regions.

Critical Phase Dualities in 1D Exactly Solvable Quasiperiodic Models.

We propose a solvable class of 1D quasiperiodic tight-binding models encompassing extended, localized, and critical phases, separated by nontrivial mobility edges. Limiting cases include the Aubry-André model and the models of Sriram Ganeshan, J. H. Pixley, and S. Das Sarma [Phys. Rev. Lett. 114, 146601 (2015)PRLTAO0031-900710.1103/PhysRevLett.114.146601] and J. Biddle and S. Das Sarma [Phys. Rev. Lett. 104, 070601 (2010)PRLTAO0031-900710.1103/PhysRevLett.104.070601]. The analytical treatment follows from recognizing these models as a novel type of fixed points of the renormalization group procedure recently proposed in Phys. Rev. B 108, L100201 (2023)10.1103/PhysRevB.108.L100201 for characterizing phases of quasiperiodic structures. Beyond known limits, the proposed class of models extends previously encountered localized-delocalized duality transformations to points within multifractal critical phases. Besides an experimental confirmation of multifractal duality, realizing the proposed class of models in optical lattices allows stabilizing multifractal critical phases and nontrivial mobility edges in an undriven system without the need for the unbounded potentials required by previous proposals.

Quantum Biochemistry Screening and In Vitro Evaluation of Leishmania Metalloproteinase Inhibitors.

Leishmanolysin, also known as major promastigote protease (PSP) or gp63, is the most abundant surface glycoprotein of Leishmania spp., and has been extensively studied and recognized as the main parasite virulence factor. Characterized as a metalloprotease, gp63 can be powerfully inactivated in the presence of a metal chelator. In this study, we first used the structural parameters of a 7-hydroxycoumarin derivative, L1 compound, to evaluate the theoretical-computational experiments against gp63, comparing it with an available metal chelator already described. The methodology followed was (i) analysis of the three-dimensional structure of gp63 as well as its active site, and searching the literature and molecular databases for possible inhibitors; (ii) molecular docking simulations and investigation of the interactions in the generated protein-ligand complexes; and (iii) the individual energy of the gp63 amino acids that interacted most with the ligands of interest was quantified by ab initio calculations using Molecular Fraction with Conjugated Caps (MFCC). MFCC still allowed the final quantum balance calculations of the protein interaction to be obtained with each inhibitor candidate binder. L1 obtained the best energy quantum balance result with -2 eV, followed by DETC (-1.4 eV), doxycycline (-1.3 eV), and 4-terpineol (-0.6 eV), and showed evidence of covalent binding in the enzyme active site. In vitro experiments confirmed L1 as highly effective against L. amazonensis parasites. The compound also exhibited a low cytotoxicity profile against mammalian RAW and 3T3 cells lines, presenting a selective index of 149.19 and 380.64 µM, respectively. L1 induced promastigote forms' death by necrosis and the ultrastructural analysis revealed disruption in membrane integrity. Furthermore, leakage of the contents and destruction of the parasite were confirmed by Spectroscopy Dispersion analysis. These results together suggested L1 has a potential effect against L. amazonensis, the etiologic agent of diffuse leishmaniasis, and the only one that currently does not have a satisfactory treatment.

Phylogeny, divergence times, and diversification in Calophyllaceae: Linking key characters and habitat changes to the evolution of Neotropical Calophylleae.

The clusioid clade comprises five monophyletic families: Bonnetiaceae, Calophyllaceae, Clusiaceae s.s., Hypericaceae, and Podostemaceae. Even though the circumscription of these families is well established, phylogenetic relationships within some families remain unresolved. This study aims to infer phylogenetic relationships within the Neotropical Calophylleae based on a broad sampling of taxa and a multilocus approach. We then use our phylogenetic framework as basis to investigate the evolution and biogeography of Calophylleae and diversification shifts in Calophyllaceae. To reconstruct the phylogeny of the Neotropical Calophylleae, we used five plastid (matK, ndhF, rbcL, psbA-trnH, and trnK), two mitochondrial (matR and rps3), and two nuclear (EMB2765 and ITS) markers, including previously published and newly generated sequences. We sampled 74 species, increasing sampling of Neotropical taxa by 500%. Our phylogenetic hypothesis for Calophyllaceae provides additional support for the monophyly of all genera and allowed us to identify four main clades: Calophyllum, Kayea, Mammea, and the Neotropical clade. The Neotropical clade includes three main lineages, a small clade composed of Clusiella and Marila, and a large HaCaKi clade (i.e., Haplocarpa, Caraipa, and Kilmeyera) that is sister to Mahurea exstipulata. The evolution of three morphological traits (i.e., fleshy fruits, anther glands, and winged seeds) were shown to be associated with changes in evolutionary dynamics in Calophyllaceae, while a biome shift was detected in Kielmeyera, affecting net diversification within this genus. Major geological and climatic events such as the Andean uplift and a gradual decrease in temperatures seem to have influenced diversification rates within the Neotropical Calophylleae.

Advanced understanding of phylogenetic relationships, morphological evolution and biogeographic history of the mega-diverse plant genus Myrcia and its relatives (Myrtaceae: Myrteae).

Myrcia is the largest exclusively Neotropical genus of the plant family Myrtaceae with c. 770 species. Although several studies have elucidated the relationships within particular sections of the genus, to date no phylogeny has been produced that includes a broad taxonomic and geographic representation. Here we present a phylogenetic hypothesis of Myrcia and close relatives comprising 253 species and based on two nuclear and seven plastid markers. We combine previously available sequence data with 234 new sequences of the genus Myrcia for this study. We use this phylogeny to investigate the evolution of selected morphological traits and to infer the biogeographic history of the genus. Our results yield a highly supported phylogenetic tree where the Myrceugenia group is sister to the Myrcia and Plinia groups. Five Myrcia species previously considered unplaced emerge in a newly circumscribed clade. The monophyly of two Myrcia sections previously considered uncertain, Aulomyrcia and Gomidesia, are confirmed with strong support. Flowers with free calyx lobes, 2-locular ovaries, and anthers with symmetrical thecae are ancestral features of Myrcia. The Myrcia sect. Gomidesia is highly supported and recovered as monophyletic, with asymmetric anthers that retain their curvature after dehiscence as a morphological synapomorphy. The Atlantic Forest is the most likely ancestral area of the genus and most of its internal clades, from where multiple lineages colonized different regions of South and Central America, in particular the Brazilian Cerrado through multiple unidirectional range expansions. The southern Atlantic Forest is the ancestral area for Myrcia sect. Gomidesia, with lineages reaching the northern Atlantic Forest, Cerrado, Yungas, and other savanna vegetation of South America. Our results provide a solid backbone for further evolutionary and taxonomic work and clarify several previously uncertain relationships in this mega-diverse plant group, and shed light on its geographical range evolution.

Testing Darwin's transoceanic dispersal hypothesis for the inland nettle family (Urticaceae).

Dispersal is a fundamental ecological process, yet demonstrating the occurrence and importance of long-distance dispersal (LDD) remains difficult, having rarely been examined for widespread, non-coastal plants. To address this issue, we integrated phylogenetic, molecular dating, biogeographical, ecological, seed biology and oceanographic data for the inland Urticaceae. We found that Urticaceae originated in Eurasia c. 69 Ma, followed by ≥ 92 LDD events between landmasses. Under experimental conditions, seeds of many Urticaceae floated for > 220 days, and remained viable after 10 months in seawater, long enough for most detected LDD events, according to oceanographic current modelling. Ecological traits analyses indicated that preferences for disturbed habitats might facilitate LDD. Nearly half of all LDD events involved dioecious taxa, so population establishment in dioecious Urticaceae requires multiple seeds, or occasional selfing. Our work shows that seawater LDD played an important role in shaping the geographical distributions of Urticaceae, providing empirical evidence for Darwin's transoceanic dispersal hypothesis.

Myrteae phylogeny, calibration, biogeography and diversification patterns: Increased understanding in the most species rich tribe of Myrtaceae.

Myrteae (c. 2500 species; 51 genera) is the largest tribe of Myrtaceae and an ecologically important groups of angiosperms in the Neotropics. Systematic relationships in Myrteae are complex, hindering conservation initiatives and jeopardizing evolutionary modelling. A well-supported and robust phylogenetic hypothesis was here targeted towards a comprehensive understanding of the relationships within the tribe. The resultant topology was used as a base for key evolutionary analyses such as age estimation, historical biogeography and diversification rate patterns. One nuclear (ITS) and seven chloroplast (psbA-trnH, matK, ndhF, trnl-trnF, trnQ-rps16, rpl16 and rpl32-trnL) DNA regions for 115 taxa representing 46 out of the 51 genera in the tribe were accessed and analysed using maximum likelihood and Bayesian inference tools for phylogenetic reconstruction. Dates of diversification events were estimated and contrasted using two distinct fossil sets (macro and pollen) in BEAST. The subsequent dated phylogenies were compared and analysed for biogeographical patterns using BioGeoBEARS and diversification rates using BAMM. Myrteae phylogeny presents strong statistical support for three major clades within the tribe: Australasian group, Myrtus group and Main Neotropical Lineage. Dating results from calibration using macrofossil are an average of 20 million years older and show an early Paleocene origin of Myrteae, against a mid-Eocene one from the pollen fossil calibration. Biogeographic analysis shows the origin of Myrteae in Zealandia in both calibration approaches, followed by a widespread distribution throughout the still-linked Gondwana continents and diversification of Neotropical endemic lineages by later vicariance. Best configuration shift indicates three points of acceleration in diversification rates, all of them occurring in the Main Neotropical Lineage. Based on the reconstructed topology, several new taxonomic placements were recovered, including: the relative position of Myrtus communis, the placement of the Blepharocalyx group, the absence of generic endemism in the Caribbean, and the paraphyletism of the former Pimenta group. Distinct calibration approaches affect biogeography interpretation, increasing the number of necessary long distance dispersal events in the topology with older nodes. It is hypothesised that biological intrinsic factors such as modifications of embryo type and polyploidy might have played a role in accelerating shifts of diversification rates in Neotropical lineages. Future perspectives include formal subtribal classification, standardization of fossil calibration approaches and better links between diversification shifts and trait evolution.

Subcycle dynamics of excitons under strong laser fields.

Excitons play a key role in the linear optical response of two-dimensional (2D) materials. However, their role in the nonlinear response to intense, nonresonant, low-frequency light is often overlooked as strong fields are expected to tear the electron-hole pair apart. Using high-harmonic generation as a spectroscopic tool, we theoretically study their formation and role in the nonlinear optical response. We show that the excitonic contribution is prominent and that excitons remain stable even when the driving laser field surpasses the strength of the Coulomb field binding the electron-hole pair. We demonstrate a parallel between the behavior of strongly laser-driven excitons in 2D solids and strongly driven Rydberg states in atoms, including the mechanisms of their formation and stability. Last, we show how the excitonic contribution can be singled out by encapsulating the 2D material in a dielectric, tuning the excitonic energy and its contribution to the high-harmonic spectrum.

Relationship between fruit phenotypes and domestication in hexaploid populations of biribá (Annona mucosa) in Brazilian Amazonia.

Background: Biribá (Annona mucosa Jacq.) is a fruit tree domesticated in Amazonia and has polyploid populations. The species presents ample phenotypic variation in fruit characteristics, including weight (100-4,000 g) and differences in carpel protrusions. Two cytotypes are recorded in the literature (2n = 28, 42) and genome size records are divergent (2C = 4.77, 5.42 and 6.00 pg). To decipher the role of polyploidy in the domestication of A. mucosa, we examined the relationships among phenotypic variation, chromosome number and genome size, and which came first, polyploidization or domestication. Methodology: We performed chromosome counts of A. mucosa from central and western Brazilian Amazonia, and estimated genome size by flow cytometry. We performed phylogenetic reconstruction with publicly available data using a Bayesian framework, time divergence analysis and reconstructed the ancestral chromosome number for the genus Annona and for A. mucosa. Results: We observed that variation in fruit phenotypes is not associated with variation in chromosome number and genome size. The most recent common ancestor of A. mucosa is inferred to be polyploid and diverged before domestication. Conclusions: We conclude that, when domesticated, A. mucosa was already polyploid and we suggest that human selection is the main evolutionary force behind fruit size and fruit morphological variation in Annona mucosa.

The Evolution of Cytogenetic Traits in Cuscuta (Convolvulaceae), the Genus With the Most Diverse Chromosomes in Angiosperms.

Karyotypes are characterized by traits such as chromosome number, which can change through whole-genome duplication and dysploidy. In the parasitic plant genus Cuscuta (Convolvulaceae), chromosome numbers vary more than 18-fold. In addition, species of this group show the highest diversity in terms of genome size among angiosperms, as well as a wide variation in the number and distribution of 5S and 35S ribosomal DNA (rDNA) sites. To understand its karyotypic evolution, ancestral character state reconstructions were performed for chromosome number, genome size, and position of 5S and 35S rDNA sites. Previous cytogenetic data were reviewed and complemented with original chromosome counts, genome size estimates, and rDNA distribution assessed via fluorescence in situ hybridization (FISH), for two, seven, and 10 species, respectively. Starting from an ancestral chromosome number of x = 15, duplications were inferred as the prevalent evolutionary process. However, in holocentric clade (subgenus Cuscuta), dysploidy was identified as the main evolutionary mechanism, typical of holocentric karyotypes. The ancestral genome size of Cuscuta was inferred as approximately 1C = 12 Gbp, with an average genome size of 1C = 2.8 Gbp. This indicates an expansion of the genome size relative to other Convolvulaceae, which may be linked to the parasitic lifestyle of Cuscuta. Finally, the position of rDNA sites varied mostly in species with multiple sites in the same karyotype. This feature may be related to the amplification of rDNA sites in association to other repeats present in the heterochromatin. The data suggest that different mechanisms acted in different subgenera, generating the exceptional diversity of karyotypes in Cuscuta.

Building a microneurosurgical laboratory in Latin America: challenges and possibilities.

BACKGROUND: Training in microsurgical neuroanatomy is a priority for neurosurgical education. During the 20th century, microsurgical laboratories arose and provided a way to develop surgical skills. Few reports addressed the assembly, construction, and details of a training laboratory. METHODS: We have conducted a literature review and searched legislation on the need to plan the structure of the laboratory. RESULTS: We projected and built a laboratory through a public-private partnership. High-tech workstations and instruments were planned to meet the needs of residents, fellows, and student. All steps and materials were in accordance with the Brazilian legislation and articles previously selected. CONCLUSION: We described our experience and demonstrated the implementation of a micro neurosurgical skills laboratory.

Cerebral abscess secondary to embolization of arteriovenous malformation: A case report and literature review.

BACKGROUND: Infectious complications of the central nervous system secondary to endovascular procedures have rarely been reported. However, the number of complications has grown exponentially owing to the popularization of these procedures. The success rate of these procedures varies with the pathology, the patient, and surgical performance. Although brain abscesses have been extensively reported, their presence after endovascular procedures has not been described in detail in the literature. We present a case of brain abscess induced by embolization of an arteriovenous malformation (AVM), discuss the main indications, techniques, procedural complications, and review the associated literature. CASE DESCRIPTION: A 13-year-old boy presented to us with a history of hemorrhagic stroke secondary to a cerebral AVM rupture. He underwent incomplete AVM resection (2014), with subsequent incomplete embolization (2017), and permanence of the endovenous catheter as a procedural complication. Physical examination revealed purulent exudate through the cervical surgical wound. We performed cervicotomy to remove the catheter but had no success in removing the intracranial material segment. The patient was subsequently diagnosed with a brain abscess (2018) and treated with antibiotics. Our team performed resection of the residual AVM, abscess, and the catheter-associated with the region. CONCLUSION: The patient showed significant clinical improvement after surgical resection of the malformation. No residual lesions were observed in the imaging examinations. Further, we reviewed the literature to find other cases of similar complications and their association with the endovascular procedure. We did not find complications in patients younger than the one presented in this case. Factors such as incomplete embolisation increase the risk of unfavourable outcomes.

Anterior Clinoidectomy: Intradural Step-by-Step En Bloc Removal Technique.

OBJECTIVE: Anterior clinoidectomy is an important and essential skill for skull base and cerebrovascular neurosurgeons. We present a 1-piece intradural anterior clinoidectomy, providing a step-by-step description of the technique, independently of anatomic variations. METHODS: Between 2014 and 2020, 128 patients (119 women and 9 men; average age, 54.6 years) underwent intradural anterior clinoidectomy during microsurgical clipping of carotid-ophthalmic aneurysms. RESULTS: The anterior clinoid process continues medially with the planum sphenoidale, over the optic nerve, laterally with the lesser wing of the sphenoid bone, and inferiorly with the optic strut, which is always found anteriorly to the clinoid segment of the internal carotid artery, and separates the optic canal from the superior orbital fissure. The proposed anterior clinoidectomy followed, one after the other, these 3 fixation points for the detachment of the anterior clinoid process. The main indication for intradural anterior clinoidectomy was the management of vascular lesions around paraclinoid (clinoidal and ophthalmic) segments of the internal carotid artery. Complications of the procedure included injury to the internal carotid artery or the ophthalmic artery, thermal damage to the optic nerve, and invasion of the sphenoid sinus or a pneumatized anterior clinoid process, which could lead to postoperative cerebrospinal fluid leakage. CONCLUSIONS: The anterior clinoidectomy technique described here minimizes the drilling surface for detachment of the anterior clinoid process and reduces operative time as well as the amount of bone dust produced by drilling. It also precisely delineates the localization of the optic strut, preventing carotid or optic nerve damage.

Combined treatment for a hemispheric cerebellar AVM.

Posterior fossa arteriovenous malformations (AVMs) can be a challenging disease, especially those large in size. AVMs can be treated with a combination of endovascular treatment and microsurgery. Here, the authors present the case of a 16-year-old female patient with progressive dizziness and episodic syncope. The workup of the patient showed a hemispheric cerebellar AVM, Spetzler-Martin grade IV. She underwent combined treatment (endovascular and microsurgery) with no complications and cure of the malformation. The video can be found here: https://youtu.be/rNw_Kyd76Mg.

Microsurgical treatment for cerebellomesencephalic fissure arteriovenous malformations after multiple sessions of endovascular treatment.

BACKGROUND: Arteriovenous malformations (AVMs) are relatively uncommon congenital vascular anomalies, and only 7-15% of AVMs occur in the posterior fossa. Most posterior fossa AVMs clinically present with hemorrhage and are associated with a high risk of neurological deficits and mortality. These malformations are associated with a high incidence of flow-related aneurysms. Endovascular treatment of infratentorial AVMs is challenging in pediatric patients. CASE DESCRIPTION: We describe an 11-year-old female adolescent with cerebellar syndrome [Video 1], who was diagnosed with a cerebellomesencephalic fissure AVM. We observed a sequential increase in the size of the AVM after multiple sessions of endovascular treatment and performed successful microsurgical resection of the lesion. CONCLUSION: This illustrative video highlights the role of microsurgery as a feasible therapeutic strategy for complete resection of cerebellar AVMs after endovascular embolization.

Toxicidades Gastrointestinais em Mulheres durante Tratamento Quimioterápico do Câncer de Mama / Gastrointestinal Toxicities in Women During Breast Cancer Chemotherapy Treatment / Toxicidades Gastrointestinales en Mujeres durante el Tratamiento de Quimioterapia del Cáncer de Mama

Introdução: Os agentes quimioterápicos para o tratamento do câncer de mama frequentemente provocam toxicidades sistêmicas nas pacientes, incluindo alterações gastrointestinais. Objetivo: Identificar toxicidades gastrointestinais em mulheres durante o tratamento quimioterápico do câncer de mama. Método: Estudo descritivo-exploratório, quantitativo e transversal, utilizando prontuários médicos de pacientes em quimioterapia entre fevereiro de 2014 e fevereiro de 2015 em um serviço de oncologia. Após rastreamento e seleção, foram incluídas 194 pacientes. Resultados: De modo geral, foram identificadas 457 manifestações clínicas gastrointestinais, das quais 50,5% das participantes apresentaram até duas e 49,5% apresentaram entre três e cinco. Além disso, 74,2% apresentaram náusea, 43,3% dor abdominal, 40,7% diarreia, 39,2% vômito e 37,6% constipação. A ocorrência de três a cinco toxicidades esteve relacionada com a ocorrência de fadiga (p=0,002) e perda de peso (p=0,003), bem como a quantidade de ciclos quimioterápicos influenciou positivamente na severidade de náusea (p=0,041) e vômito (p=0,023). Os agentes quimioterápicos experimentados não influenciaram nessas toxicidades. Por fim, houve náusea e vômito [...]

Introduction: Chemotherapeutic agents for breast cancer treatment often cause systemic toxicities in patients, including gastrointestinal alterations. Objective: To identify gastrointestinal toxicities in women during breast cancer chemotherapy. Method: Descriptive-exploratory, quantitative and cross-sectional study using medical records of patients undergoing chemotherapy between February 2014 and February 2015 in an oncology service. After screening and selection, 194 patients were included. Results: In general, 457 gastrointestinal clinical manifestations were identified, of which 50.5% of the participants had up to two and 49.5% had between three and five. In addition, 74.2% had nausea, 43.3% abdominal pain, 40.7% diarrhea, 39.2% vomiting and 37.6% constipation. The occurrence of three to five toxicities was related to the occurrence of fatigue (p=0.002) and weight loss (p=0.003), as well as the number of chemotherapy cycles positively influenced the severity of nausea (p=0.041) and vomiting (p=0.023). The chemotherapeutic agents taken did not influence the occurrence of these toxicities. Lastly, nausea and vomiting [...]

Introducción: Los agentes quimioterapéuticos para el tratamiento del cáncer de seno a menudo causan toxicidades sistémicas en pacientes, incluidos alteraciones gastrointestinales. Objetivo: Identificación de toxicidades gastrointestinales en mujeres durante la quimioterapia contra el cáncer de mama. Método: Estudio descriptivo-exploratorio, cuantitativo y transversal utilizando historias clínicas de pacientes sometidos a quimioterapia entre febrero de 2014 y febrero de 2015 en un servicio de oncología. Después del cribado y la selección, se incluyeron 194 pacientes. Resultados: En general, se identificaron 457 manifestaciones clínicas gastrointestinales, de las cuales el 50,5% de los participantes tenían hasta dos y el 49,5% tenían entre tres y cinco. Además, 74,2% tenía náuseas, 43,3% dolor abdominal, 40,7% diarrea, 39,2% vómitos y 37,6% estreñimiento. La aparición de tres a cinco toxicidades se relacionó con la aparición de fatiga (p=0,002) y pérdida de peso (p=0,003), así como el número de ciclos de quimioterapia influyó positivamente en la gravedad de las náuseas (p=0,041) y los vómitos (p=0,023). Los agentes quimioterapéuticos experimentados no influyeron en la aparición de estas toxicidades. Finalmente, la aparición de náuseas y vómitos[...]

Primary school educational intervention r egarding schistosomiasis in a riverside community, northeastern Brazil

Schistosomiasis is still a serious public health concern in Brazil and Sergipe State presents the highest prevalence rate of the disease. Brazil implemented the Schistosomiasis Control Program (PCE) with several strategies to control the disease, including health education actions in endemic areas. Herein, we assessed the impact of an educational intervention on knowledge concerning schistosomiasis in students from a riverside village of Sergipe, Northeastern Brazil. The study was carried out in 3 phases. 1) A questionnaire was applied to assess the students' knowledge about the biological, clinical, and epidemiological aspects of schistosomiasis mansoni (pre-test). 2) Next, an educational intervention was conducted. Pamphlets about schistosomiasis were distributed to the entire school community, who were then invited to a lecture. 3) A post-test was performed using the questionnaire to assess acquired knowledge. 151 elementary school students were interviewed. 2.6% of the pre-test students and 4.3% of the post-test group had already been diagnosed with schistosomiasis. In the pre-test, only 24.5% knew the cause of the disease and 48.3% the transmission sites. In the post-test, 74.3% (OR= 8.9; p-value<0.0001) knew the etiology and 77.1% the possible transmission sites (OR= 3.6; p-value<0.0001). There was also significant improvement in knowledge regarding signs, symptoms and prophylactic measures. Most students were unaware of the risk of reinfection by Schistosoma mansoni after treatment. The educational intervention proved quite effective in increasing information on schistosomiasis. These results reinforce the importance of health education as an auxiliary tool in the control of schistosomiasis.