Introduction: in recent years, there have been numerous scientific publications on gender diversity in children and adolescents along with establishment of medical and psychological services to serve this population. This increased visibility is the result of a more tolerant social and cultural context; however, there are still barriers and prejudices that these children and their families have to face in the process of self-acceptance and in their relationship with the different social settings of their lives. Sample and methods: qualitative study through individual in-depth interviews with 6 parents of trans children of different ages in the Community of Madrid. Results: we present the results organised in 3 main categories: the pathway of parents (the phases of understanding and accepting gender diversity in their children); the pathway of children (social transition and its emotional and psychological impact); the pathway of society (the relationships and dynamics between these families and their social environment). The latter category includes a specific section about the relationship with the health care system. Conclusions: the narratives collected in the interviews evinced the presence of a virtuous circle that arose from the recognition of the gender diversity in these children and involving the love of parents and inclusion in society. This allows for the change in perspective required to become aware that the only disease that we need to fight is transphobia.

Introducción: en los últimos años están apareciendo numerosas publicaciones científicas y unidades de atención médica y psicológica para la diversidad de género en menores. Este aumento de visibilidad es consecuencia de un contexto sociocultural de mayor tolerancia; sin embargo, quedan todavía obstáculos y prejuicios que estos menores y sus familias tienen que afrontar en el proceso de su propia aceptación y en la relación con los diferentes entornos sociales de sus vidas. Método y participantes: estudio cualitativo mediante seis entrevistas individuales en profundidad a padres y madres de menores trans de diferentes edades en la Comunidad de Madrid. Resultados y discusión: la presentación de los resultados se realizará a través de tres categorías principales: el tránsito de los progenitores (las fases del proceso de comprensión y aceptación de la diversidad de género de sus hijas e hijos); el tránsito de los menores (el tránsito social y sus consecuencias emocionales y psicológicas); el tránsito de la sociedad (las relaciones y las dinámicas que se instauran entre estas familias y su entorno social. Dentro de esta categoría se incluye un apartado específico respecto a la relación con la sanidad). Conclusiones: los relatos recogidos en las entrevistas dibujan un círculo virtuoso que surge del reconocimiento de la diversidad de género de estos menores y que pasa por el amor de sus progenitores y de su inclusión en la sociedad. Esto permite un cambio de mirada necesario para plantearnos que la única enfermedad contra la que luchar es la transfobia.

Abstract Celiac disease can be considered the great pretender (as syphilis some years ago). A prevalent disease with different presentations, including silent ones. In relation to diet with cereals, other non-celiac diseases are appearing, that also improve removing wheat. The fact that it´s being diagnosed in adults, adds complexity because protocols are somehow different than protocols in children. New data about celiac disease and other syndromes related to cereals help clarify practical management.

Resumen La celiaquía puede considerarse (como antes la sífilis) la gran simuladora. Una enfermedad prevalente con nuevos matices y diferentes formas de presentación, incluyendo la silente. En relación con la ingesta de cereales están apareciendo otras enfermedades no celíacas, pero que mejoran al retirar el trigo. En este artículo se hace una actualización de la celiaquía y de las enfermedades relacionadas con la ingesta de cereales.

Urban visceral leishmaniasis is an emerging zoonosis in Argentina. In the Americas the disease is produced by Leishmania infantum, with dogs as the primary reservoir and phlebotomine sandflies as the vectors. This article presents the experience acquired by professionals from the National Leishmaniasis Program in Argentina as visceral leishmaniasis has emerged and spread, especially in clinical and laboratory diagnosis, disease treatment, vector biology, reservoir management, and conflicts regarding recommendations for infected dogs. Early detection and treatment, along with decentralized and horizontal strategies, will contribute to the decrease in morbidity and mortality associated with visceral leishmaniasis. Control over the transmission and spread of the disease requires integral environmental management and responsible dog ownership. The interests and discourses put into conflict by visceral leishmaniasis are discussed in the framework of the human-dog relationship, and the search for a consensus-based risk discourse is proposed.

La leishmaniasis visceral urbana es una zoonosis emergente en Argentina. En América es producida por Leishmania infantum, con el perro como reservorio principal e insectos flebotomíneos como vectores. En este artículo se presenta el conocimiento acumulado a partir de su emergencia y dispersión en el país, por los referentes del Programa Nacional de Leishmaniasis, en el diagnóstico clínico y de laboratorio, tratamiento, biología de vectores, manejo de reservorio, y el conflicto generado con las acciones recomendadas en relación con los perros infectados. La detección temprana y el tratamiento precoz, con estrategias descentralizadas y horizontales, contribuirán a disminuir la morbimortalidad asociada a la leishmaniasis visceral. El control de su transmisión y dispersión requiere de un manejo ambiental integral y la tenencia responsable de perros. Se discuten los intereses y discursos en conflicto generados por la leishmaniasis visceral en el marco de la relación humano-perro, proponiendo la búsqueda de un discurso consensuado de riesgo.

Urban visceral leishmaniasis is an emerging zoonosis in Argentina. In the Americas the disease is produced by Leishmania infantum, with dogs as the primary reservoir and phlebotomine sandflies as the vectors. This article presents the experience acquired by professionals from the National Leishmaniasis Program in Argentina as visceral leishmaniasis has emerged and spread, especially in clinical and laboratory diagnosis, disease treatment, vector biology, reservoir management, and conflicts regarding recommendations for infected dogs. Early detection and treatment, along with decentralized and horizontal strategies, will contribute to the decrease in morbidity and mortality associated with visceral leishmaniasis. Control over the transmission and spread of the disease requires integral environmental management and responsible dog ownership. The interests and discourses put into conflict by visceral leishmaniasis are discussed in the framework of the human-dog relationship, and the search for a consensus-based risk discourse is proposed.

La leishmaniasis visceral urbana es una zoonosis emergente en Argentina. En América es producida por Leishmania infantum, con el perro como reservorio principal e insectos flebotomíneos como vectores. En este artículo se presenta el conocimiento acumulado a partir de su emergencia y dispersión en el país, por los referentes del Programa Nacional de Leishmaniasis, en el diagnóstico clínico y de laboratorio, tratamiento, biología de vectores, manejo de reservorio, y el conflicto generado con las acciones recomendadas en relación con los perros infectados. La detección temprana y el tratamiento precoz, con estrategias descentralizadas y horizontales, contribuirán a disminuir la morbimortalidad asociada a la leishmaniasis visceral. El control de su transmisión y dispersión requiere de un manejo ambiental integral y la tenencia responsable de perros. Se discuten los intereses y discursos en conflicto generados por la leishmaniasis visceral en el marco de la relación humano-perro, proponiendo la búsqueda de un discurso consensuado de riesgo.

Novas alternativas terapêuticas contra a leishmaniose são ainda uma prioridade. A atividade da azitromicina contra a Leishmania (Leishmania) major foi anteriormente demonstrada. Diferentes respostas entre as espécies de Leishmania fazem com que um screening de drogas específicas para espécies seja necessário. A atividade da azitromicina contra a Leishmania (Viannia) braziliensis e a Leishmania (Leishmania) amazonensis foi avaliada em Golden hamsters infectados a través de injeções de promastigotas metacíclicas e comparando com controles sem tratamento e animais tratados com antimoniato de N-metil-glucamina. Foram analisadas a espessura da pata, a cultura das lesões e disseminação para órgãos internos. A azitromicina oral em dose de 450mg/kg não teve atividade contra a infecção por Leishmania ( Leishmania) amazonensis. Para infecções devidas à Leishmania (Viannia) braziliensis, a azitromicina teve uma atividade significativa em relação aos controles sem tratamento, mas foi inferior ao antimoniato de N-metil-glucamina quanto ao controle do tamanho das lesões. Nenhuma das drogas conseguiu eliminar totalmente os parasitos das lesões. Foi concluído que a azitromicina tem atividade contra Leishmania (Viannia) braziliensis, mas não tem atividade contra Leishmania (Leishmania) amazonensis neste modelo.

New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania (Leishmania) major has been previously demonstrated. Different responses among species of Leishmania make species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis was evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, azithromycin demonstrated significant activity relative to untreated controls, but inferior to meglumine antimoniate, for controlling lesion size. Neither drug was able to totally eliminate parasites from the lesions. It was concluded that azithromycin has activity against Leishmania (Viannia) braziliensis but not against Leishmania (Leishmania) amazonensis in this model.