Resumen Antecedentes: El cáncer de células pequeñas (CPCP) representa el 13-15% del total de neoplasias primarias de pulmón. Se caracteriza por su rapidez en la tasa de crecimiento y en el desarrollo de metástasis a distancia. Objetivos: Orientar y estandarizar el tratamiento del CPCP enfermedad extensa en México basado en evidencia clínica nacional e internacional. Material y métodos: Este documento se desarrolló como una colaboración del Instituto Nacional de Cancerología y la Sociedad Mexicana de Oncología en cumplimiento con estándares internacionales. Se integró un grupo conformado por oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados: Se consensaron, por el método Delphi y en reuniones a distancia, las recomendaciones en CPCP enfermedad extensa, producto de preguntas de trabajo. Se identificó y evaluó la evidencia científica que responde a cada una de dichas preguntas clínicas antes de incorporarla al cuerpo de la guía. Conclusión: Esta guía proporciona recomendaciones clínicas para el manejo de la enfermedad extensa del CPCP y durante el proceso de toma de decisiones de los clínicos involucrados con su manejo en nuestro país para mejorar la calidad de la atención clínica para estos pacientes.

Abstract Background: Small cell lung cancer (SCLC) represents 13-15% of all primary lung neoplasms and is characterized by its rapid growth rate and the rapid development of distant metastases. Objectives: To guide and standardize the treatment of extensive disease small cell lung cancer in Mexico based on national and international clinical evidence. Material and methods: This document was developed as a collaboration between the National Cancer Institute and the Mexican Society of Oncology in compliance with international standards. An interdisciplinary group was formed, including medical oncologists, oncological surgeons, thoracic surgeons, radiation oncologists, and methodologists with experience in systematic reviews of the literature and clinical practice guidelines. Results: A consensus was reached, both by the Delphi method and in remote meetings, of extensive disease recommendations resulting from work questions. The scientific evidence that answers each of these clinical questions was identified and critically evaluated, before being incorporated into the body of evidence of the Guide. Conclusions: This Clinical Practice Guide provides clinical recommendations for the management of extensive disease of SCLC to contribute to the decision-making process of the clinicians involved with its management in our country, hoping that this will contribute to improving the quality of clinical care in these patients.

Resumen Antecedentes: El cáncer de células pequeñas (CPCP) representa el 13-15% del total de neoplasias primarias de pulmón. Se caracteriza por su rapidez en la tasa de crecimiento y en el desarrollo de metástasis a distancia. Objetivos: Orientar y estandarizar el tratamiento del CPCP, enfermedad limitada, en México, basado en evidencia clínica nacional e internacional. Material y métodos: Este documento se desarrolló como una colaboración entre el Instituto Nacional de Cancerología y la Sociedad Mexicana de Oncología en cumplimiento con estándares internacionales. Se integró un grupo conformado por oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados: Se consensuaron, por el método Delphi y en reuniones a distancia, las recomendaciones en CPCP enfermedad limitada, producto de las preguntas de trabajo. Se identificó y evaluó críticamente la evidencia científica que responde a cada una de dichas preguntas clínicas, antes de incorporarla a la guía. Conclusión: Esta guía proporciona recomendaciones clínicas para el manejo de la enfermedad limitada del CPCP y durante el proceso de toma de decisiones de los clínicos involucrados con su manejo en nuestro país para mejorar la calidad de la atención clínica en estos pacientes.

Abstract Background: Small cell lung cancer (SCLC) represents 13-15% of all primary lung neoplasms and is characterized by rapid growth rate and development of distant metastases. Objectives: To guide and standardize the treatment of limited disease small cell lung cancer in Mexico based on national and international clinical evidence. Material and methods: This document was developed as a collaboration between the National Cancer Institute and the Mexican Society of Oncology in compliance with international standards. An interdisciplinary group was formed, including medical oncologists, oncological surgeons, thoracic surgeons, radiation oncologists, and methodologists with experience in systematic reviews of the literature and clinical practice guidelines. Results: Consensus recommendations were reached, both by the Delphi method and in remote meetings, for limited SCLC disease resulting from the same number of work questions. The scientific evidence that answers each of these clinical questions was identified and critically evaluated, before being incorporated into the body of evidence of the guide. Conclusion: This guide provides clinical recommendations for the management of limited disease SCLC to contribute to the decision-making process of the clinicians involved with its management in our country, hoping that this will contribute to improving the quality of clinical care in these patients.

Resumen La autosuficiencia alimentaria es un tema político relevante en muchos países, desarrollados y en desarrollo, particularmente para satisfacer las necesidades nutricionales internas de la población y enfrentar situaciones en las que los precios de los productos básicos son inestables o cuando un país enfrenta un shock externo. Mejorar la resiliencia implica fortalecer las comunidades rurales locales para satisfacer la demanda con producción interna. Los países miembros de América Latina y el Caribe (LCN) producen suficientes alimentos para sustentar a su población y para ser uno de los mayores exportadores mundiales de alimentos. A partir de la discusión teórica y usando datos de la FAO, la investigación muestra que, existe un potencial para mejorar la soberanía alimentaria y para definir las políticas alimentarias y agrícolas a través de la complementariedad agrícola entre los países de LCN. Desviar parte del comercio actual con terceros al comercio intrarregional, para productos en los que la región tiene una ventaja comparativa, representaría que los países de LCN podrían ahorrar hasta 2.700 millones de dólares al año, es decir, 6.8% del total de las importaciones de alimentos en 2018, evitando la salida de divisas y promoviendo una mayor integración económica entre los países.

Abstract Food self-sufficiency is a relevant political issue in many countries, developed and developing, particularly to satisfy the internal nutritional needs of the population and face situations in which the prices of basic products are unstable or when a country faces an external shock. Improving resilience involves strengthening local rural communities to meet demand with domestic production. The member countries of Latin America and the Caribbean (LCN) produce enough food to sustain their population and to be one of the world's largest food exporters. From the theoretical discussion and using data from FAO, the research shows that there is a potential to improve food sovereignty and to define food and agricultural policies through agricultural complementarity among the LCN countries. Diverting part of the current trade with third parties to intraregional trade, for products in which the region has a comparative advantage, would mean that LCN countries could save up to 2.7 billion dollars per year, that is, 6.8% of total imports of food in 2018, avoiding the outflow of foreign currency and promoting greater economic integration between countries.

Resumen Hydroptilidae es una de las familias más diversas del orden Trichoptera en el mundo. En el Neotrópico se han reportado 36 géneros y en Colombia se han registrado 14 en estado larval y 11 en estado adulto. Se registra por primera vez para Colombia la larva de Byrsopteryx. La larva se encontró en el río Orotoy (919 m s.n.m.), corriente del piedemonte del flanco oriental de la Cordillera Oriental del país (Orinoquia). El tramo se caracterizó por ser de tipo cascada, corriente rápida sobre rocas y guijarros, vegetación riparia conservada con dosel abierto y suelo franco-arcilloso. La temperatura del agua era de 19,7 °C, el pH de 5,8, la conductividad de 15,6 μS/cm y el oxígeno disuelto de 9,19,7 mg/1 O2. Dada la gran diversidad de ecosistemas acuáticos y el escaso conocimiento de géneros de esta familia en Colombia, se espera que en un futuro cercano se aunen esfuerzos que fomenten la investigación y el descubrimiento de nuevas especies para el país.

Abstract Hydroptilidae is one of the most diverse families of the order Trichoptera in the world. Neotropical fauna has 36 genera. In Colombia, 14 have been reported in the larval stage and 11 in the adult stage. In the present study, a Byrsopteryx larva is registered for the first time in Colombia. The larva was found in the Orotoy River (919 MASL), a stream from the foothills of the eastern flank of the country's Eastern Cordillera (Orinoquia) characterized as waterfall current with riffle on rocks and pebbles, preserved riparian vegetation with open canopy, and clay-loam soil. The water temperature was 19.7 °C, pH 5.8, conductivity 15.6 μS/cm, and dissolved oxygen 9.1-9.7 mg/lO2. Given the high diversity of aquatic ecosystems and the limited knowledge of Hydroptilidae genera in Colombia, we hope to open the way for new research and discovery of more species in the country.

Abstract: SARS-CoV-2 virus represents a challenge for society in all countries, Mexico is no exception to this problem. The country has medical societies at the forefront without a doubt and with the academic capacity to prepare the attention of the population. Medical societies play an important role in preparing and updating their members. The creation of a committee is recommended in each of them that can follow up on the pandemic and the needs it may have, particularly depending on the specialty or branch of medicine. It is important to have a support program for members, especially in the acquisition of protective equipment (respirators, googles, masks, among others). Establish protocols and recommendations that can be evaluated in order to establish future actions in order to have better attention to the population, reducing the possibility of contagion.

Resumen: La contingencia por el virus SARS-CoV-2 representa un reto para la sociedad en todos los países, México no es la excepción a este problema. El país cuenta con sociedades médicas a la vanguardia y con la capacidad académica para poder preparar la atención de la población. Las sociedades médicas desempeñan un papel importante en la preparación y actualización de sus agremiados. Se recomienda la formación de un comité en cada una de ellas que sea capaz de dar seguimiento a la pandemia y a las necesidades que puedan tener en particular según la especialidad o rama de la medicina. Contar con un programa de apoyo a miembros, sobre todo en la adquisición de equipos de protección (respiradores, lentes de protección, caretas, entre otros). Establecer protocolos y recomendaciones que puedan evaluarse para establecer a futuro acciones dirigidas a dar una mejor atención a la población disminuyendo la posibilidad de contagios.

RESUMO: Objetivo: O uso de antidepressivos está aumentando em todo o mundo, mas faltam dados nacionais sobre o uso de drogas psicotrópicas por pacientes deprimidos no Brasil. Metodologia: Entre 2013 e 2014, uma amostra representativa de indivíduos adultos urbanos foi questionada sobre a presença diagnóstica de doença crônica, a indicação médica para tratamento medicamentoso e o uso de medicamentos crônicos à época de cada diagnóstico relatado. Foram analisadas as frequências de depressão relatada e os medicamentos relacionados a essa doença. Resultados: No geral, 6,1% dos entrevistados relataram depressão. A prevalência aumentou com a idade (9,5% entre os idosos) foi maior entre as mulheres (8,9%) e no sul do país (8,9%). Como doença única, a prevalência de depressão foi maior entre os jovens (17,6%). Entre aqueles com multimorbidade, a prevalência de depressão subiu para 25,7%. Dos que relataram depressão, 81,3% tinham indicação médica para tratamento e 90,3% estavam em tratamento - essa proporção foi menor entre os jovens (84,5%) e os que moram na região mais pobre (78,6%). Os antidepressivos representaram 47,2% dos medicamentos psicotrópicos tomados pelos entrevistados com depressão, com diferenças regionais - apenas 30% usavam antidepressivos no Norte. Polifarmácia foi relatada por 22% das pessoas com depressão e outras doenças crônicas. Conclusão: A depressão no Brasil é comum entre adultos jovens como doença crônica única e altamente prevalente entre as pessoas com multimorbidade crônica, principalmente os jovens. A lacuna de tratamento foi maior entre os jovens e nas regiões menos desenvolvidas do país.

ABSTRACT: Objective: Antidepressant use is increasing worldwide, but national data on psychotropic drug use by depressed patients in Brazil is lacking. Methodology: Between 2013 and 2014, a representative sample of urban adult individuals were asked if they had a diagnosis of chronic disease, had a medical indication for drug treatment, and were taking chronic medications at the time for each reported diagnosis. We analyzed the frequencies of reported depression and the medications related to this disease. Results: Overall, 6.1% of respondents reported depression. The prevalence increased with age - 9.5% among the elders - was higher among women (8.9%) and in the south of the country (8.9%). As a single disease, the prevalence of depression was higher among young people (17.6%). Among those with multimorbidity, the prevalence of depression rose to 25.7%. Of those who reported depression, 81.3% had medical indication for treatment and 90.3% were under treatment - this proportion was lower among young people (84.5%) and those living in the poorest region (78.6%). Antidepressants accounted for 47.2% of psychotropic drugs taken by respondents with depression, with regional differences - only 30% used antidepressants in the North. Polypharmacy was reported by 22% of those with depression and other chronic diseases. Conclusion: Depression in Brazil, is common among young adults as a single chronic disease and highly prevalent among people with chronic multimorbidity, especially the young. The treatment gap was larger among young people and in the less developed regions of the country.

RESUMO: Objetivo: O uso de antidepressivos está aumentando em todo o mundo, mas faltam dados nacionais sobre o uso de drogas psicotrópicas por pacientes deprimidos no Brasil. Metodologia: Entre 2013 e 2014, uma amostra representativa de indivíduos adultos urbanos foi questionada sobre a presença diagnóstica de doença crônica, a indicação médica para tratamento medicamentoso e o uso de medicamentos crônicos à época de cada diagnóstico relatado. Foram analisadas as frequências de depressão relatada e os medicamentos relacionados a essa doença. Resultados: No geral, 6,1% dos entrevistados relataram depressão. A prevalência aumentou com a idade (9,5% entre os idosos) foi maior entre as mulheres (8,9%) e no sul do país (8,9%). Como doença única, a prevalência de depressão foi maior entre os jovens (17,6%). Entre aqueles com multimorbidade, a prevalência de depressão subiu para 25,7%. Dos que relataram depressão, 81,3% tinham indicação médica para tratamento e 90,3% estavam em tratamento - essa proporção foi menor entre os jovens (84,5%) e os que moram na região mais pobre (78,6%). Os antidepressivos representaram 47,2% dos medicamentos psicotrópicos tomados pelos entrevistados com depressão, com diferenças regionais - apenas 30% usavam antidepressivos no Norte. Polifarmácia foi relatada por 22% das pessoas com depressão e outras doenças crônicas. Conclusão: A depressão no Brasil é comum entre adultos jovens como doença crônica única e altamente prevalente entre as pessoas com multimorbidade crônica, principalmente os jovens. A lacuna de tratamento foi maior entre os jovens e nas regiões menos desenvolvidas do país.

ABSTRACT: Objective: Antidepressant use is increasing worldwide, but national data on psychotropic drug use by depressed patients in Brazil is lacking. Methodology: Between 2013 and 2014, a representative sample of urban adult individuals were asked if they had a diagnosis of chronic disease, had a medical indication for drug treatment, and were taking chronic medications at the time for each reported diagnosis. We analyzed the frequencies of reported depression and the medications related to this disease. Results: Overall, 6.1% of respondents reported depression. The prevalence increased with age - 9.5% among the elders - was higher among women (8.9%) and in the south of the country (8.9%). As a single disease, the prevalence of depression was higher among young people (17.6%). Among those with multimorbidity, the prevalence of depression rose to 25.7%. Of those who reported depression, 81.3% had medical indication for treatment and 90.3% were under treatment - this proportion was lower among young people (84.5%) and those living in the poorest region (78.6%). Antidepressants accounted for 47.2% of psychotropic drugs taken by respondents with depression, with regional differences - only 30% used antidepressants in the North. Polypharmacy was reported by 22% of those with depression and other chronic diseases. Conclusion: Depression in Brazil, is common among young adults as a single chronic disease and highly prevalent among people with chronic multimorbidity, especially the young. The treatment gap was larger among young people and in the less developed regions of the country.

Abstract INTRODUCTION: Nontuberculous mycobacteria (NTM) species, as human pathogens, are increasing in the world, as is the difficulty of accurately identifying them. Differential diagnosis, especially between the M. tuberculosis complex and NTM species, and the characterization of NTM species is important. This study aimed to evaluate the performance of a molecular system based on multiplex real-time PCR with high-resolution melting (HRM) for the identification and differentiation of NTM species of clinical importance of an endemic area for tuberculosis in northeastern Brazil. METHODS: The technical protocol of the molecular system was based on multiplex real-time PCR-HRM, and evaluated the sensitivity and specificity of the detection of NTM species in mycobacterial clinical isolates from the studied region. The gold standard method was specific gene sequencing. RESULTS: The sensitivity and specificity of multiplex real-time PCR-HRM modified for differentiation between NTM and M. tuberculosis were 90% and 100%, respectively. The PCR-HRM sensitivities for the characterization of NTM species (M. kansasii, M. abscesses, M. avium, and M. fortuitum) were 94.59%, 80%, 57.14%, and 54%, respectively. CONCLUSIONS The multiplex real-time PCR-HRM modified assay has the potential to rapidly and efficiently identify nontuberculous mycobacteria of clinical importance, which is crucial for immediate implementation of the appropriate therapy and thus avoiding complications and sequelae in patients.

Despite the need for scientific research in psychology to solve the different psychosocial problems of the country (family violence and corruption, for example), studies in this area are not still enough. One of the ways to encourage research is by doing a thesis. However, many students opt for other types of jobs for that purpose. The objective of the study is to identify, describe and explain those factors that influence the undergraduate Psychology students’ decision to do or not a thesis in order to obtain the professional degree. A qualitative methodology and the Grounded Theory design were used. We conducted 7 individual interviews and 2 focus groups of a total of 28 university students (20 women and 8 men), living in the city of Lima, 2 of them from public universities and 3 of them from private universities and who were in the last semesters of the Psychology specialty. The results suggest that there are psychological, circumstantial, family, university-related, social and cultural factors, complex interaction of which affects the psychological processes of the student to decide to do or not a thesis, representing the student’s belief system in itself and in relation to the research activity, a main psychological factor.

A pesar de la necesidad de investigaciones científicas en Psicología para dar respuesta a los diferentes problemas psicosociales del país (violencia familiar y corrupción, por ejemplo), los estudios en esta área son aún insuficientes. Una de las formas de incentivar las investigaciones es a través de la realización de tesis. Sin embargo, muchos estudiantes optan por otro tipo de trabajos para tal fin. El objetivo del estudio es identificar, describir y explicar aquellos factores que influyen en la decisión de realizar o no realizar tesis para obtener el título profesional en estudiantes de pregrado de la carrera de Psicología. Se empleó una metodología cualitativa y el diseño Teoría Fundamentada. Se realizaron 7 entrevistas individuales y 2 grupos focales a un total de 28 estudiantes universitarios (20 mujeres y 8 varones), residentes en la ciudad de Lima, de 2 universidades nacionales y 3 particulares, que cursaban los últimos ciclos de la carrera de Psicología. Los resultados sugieren que existen factores psicológicos, circunstanciales, familiares, relacionados a la universidad, sociales y culturales cuya compleja interacción influye en los procesos psicológicos del estudiante para tomar la decisión de realizar o no realizar una tesis, representando el sistema de creencias del estudiante respecto de sí mismo y en relación con la actividad de investigación un factor psicológico central.

Resumo: A tuberculose drogarresistente (TBDR) representa hoje uma grave ameaça aos avanços no controle da tuberculose (TB) no Brasil e no mundo. Neste estudo, investigam-se fatores associados ao abandono e ao óbito de casos em tratamento para TBDR, em um centro de referência terciária do Município do Rio de Janeiro, Brasil. Trata-se de um estudo de coorte retrospectiva, a partir dos casos notificados no Sistema de Informação de Tratamentos Especiais de Tuberculose (SITETB), no período de 1º de janeiro de 2012 a 31 de dezembro de 2013. Um total de 257 pacientes foi notificado no SITETB e iniciou o tratamento para TBDR. Desse total, 139 (54,1%) tiveram sucesso terapêutico como desfecho, 54 (21%) abandonaram o tratamento e 21 (8,2%) evoluíram para óbito. Após análise de regressão logística multinomial múltipla, a faixa etária acima de cinquenta anos foi observada como único fator de proteção ao abandono, ao passo que ter menos de oito anos de escolaridade e reingresso após abandono foram considerados como fatores de risco. Reingresso após abandono, recidiva e falência indicaram fatores de risco. Nossos dados reforçam a concepção de que o abandono do tratamento de tuberculose resistente é um sério problema de saúde pública, sendo necessário um adequado acompanhamento no tratamento de pacientes com esse histórico e com baixa escolaridade. Além disso, uma rede de apoio social ao paciente é imprescindível para que desfechos desfavoráveis sejam evitados.

Abstract: Drug-resistant tuberculosis (DR-TB) poses a serious threat to tuberculosis (TB) control in Brazil and worldwide. The current study investigated factors associated with loss to follow-up and death in the course of treatment for DR-TB in a tertiary reference center in the city of Rio de Janeiro, Brazil. This was a retrospective cohort study of cases reported to the Information System on Special Treatments for Tuberculosis (SITETB) from January 1, 2012, to December 31, 2013. A total of 257 patients were reported to the SITETB and initiated treatment for DR-TB. Of this total, 139 (54.1%) achieved treatment success as the outcome, 54 (21%) were lost to follow-up, and 21 (8.2%) died. Following a multiple multinomial logistic regression analysis, the age bracket older than 50 years was the only protective factor against loss to follow-up, whereas less than eight years of schooling and reentry after loss to follow-up were considered risk factors. Reentry after loss to follow-up, relapse, and treatment failure appeared as risk factors. Our data reinforce the concept that loss to follow-up in drug-resistant tuberculosis is a serious public health problem, and that adequate follow-up of treatment is necessary in patients with this history and low schooling. A social support network for patients is also indispensable for avoiding unfavorable outcomes.

Resumen: La tuberculosis farmacorresistente (TBFR) representa hoy una grave amenaza para los avances en el control de la tuberculosis (TB) en Brasil y en el mundo. En este estudio, se investigan factores asociados al abandono y al óbito de casos en tratamiento para TBDR, dentro de un centro de referencia de carácter terciario del municipio de Río de Janeiro, Brasil. Se trata de un estudio de cohorte retrospectiva, a partir de los casos notificados en el Sistema de Información de Tratamientos Especiales de Tuberculosis (SITETB), durante el período del 1 de enero de 2012 al 31 de diciembre de 2013. Un total de 257 pacientes fue notificado en el SITETB y comenzó el tratamiento para TBDR. De ese total, 139 (un 54,1%) tuvieron éxito terapéutico como desenlace, 54 (un 21%) abandonaron el tratamiento y un 21 (8,2%) evolucionaron hacia óbito. Tras el análisis de regresión logística multinomial múltiple, la franja de edad por encima de cincuenta años se observó como el único factor de protección al abandono, al mismo tiempo que tener menos de ocho años de escolaridad y reingresar en el sistema educativo tras el abandono fueron considerados como factores de riesgo. Reingreso tras abandono, recidiva e insolvencia indicaron factores de riesgo. Nuestros datos refuerzan la concepción de que el abandono del tratamiento de tuberculosis resistente es un serio problema de salud pública, siendo necesario un adecuado acompañamiento en el tratamiento de pacientes con este historial y con baja escolaridad. Además, una red de apoyo social entorno al paciente es imprescindible para que los desenlaces desfavorables sean evitados.

Resumo: A tuberculose drogarresistente (TBDR) representa hoje uma grave ameaça aos avanços no controle da tuberculose (TB) no Brasil e no mundo. Neste estudo, investigam-se fatores associados ao abandono e ao óbito de casos em tratamento para TBDR, em um centro de referência terciária do Município do Rio de Janeiro, Brasil. Trata-se de um estudo de coorte retrospectiva, a partir dos casos notificados no Sistema de Informação de Tratamentos Especiais de Tuberculose (SITETB), no período de 1º de janeiro de 2012 a 31 de dezembro de 2013. Um total de 257 pacientes foi notificado no SITETB e iniciou o tratamento para TBDR. Desse total, 139 (54,1%) tiveram sucesso terapêutico como desfecho, 54 (21%) abandonaram o tratamento e 21 (8,2%) evoluíram para óbito. Após análise de regressão logística multinomial múltipla, a faixa etária acima de cinquenta anos foi observada como único fator de proteção ao abandono, ao passo que ter menos de oito anos de escolaridade e reingresso após abandono foram considerados como fatores de risco. Reingresso após abandono, recidiva e falência indicaram fatores de risco. Nossos dados reforçam a concepção de que o abandono do tratamento de tuberculose resistente é um sério problema de saúde pública, sendo necessário um adequado acompanhamento no tratamento de pacientes com esse histórico e com baixa escolaridade. Além disso, uma rede de apoio social ao paciente é imprescindível para que desfechos desfavoráveis sejam evitados.

Abstract: Drug-resistant tuberculosis (DR-TB) poses a serious threat to tuberculosis (TB) control in Brazil and worldwide. The current study investigated factors associated with loss to follow-up and death in the course of treatment for DR-TB in a tertiary reference center in the city of Rio de Janeiro, Brazil. This was a retrospective cohort study of cases reported to the Information System on Special Treatments for Tuberculosis (SITETB) from January 1, 2012, to December 31, 2013. A total of 257 patients were reported to the SITETB and initiated treatment for DR-TB. Of this total, 139 (54.1%) achieved treatment success as the outcome, 54 (21%) were lost to follow-up, and 21 (8.2%) died. Following a multiple multinomial logistic regression analysis, the age bracket older than 50 years was the only protective factor against loss to follow-up, whereas less than eight years of schooling and reentry after loss to follow-up were considered risk factors. Reentry after loss to follow-up, relapse, and treatment failure appeared as risk factors. Our data reinforce the concept that loss to follow-up in drug-resistant tuberculosis is a serious public health problem, and that adequate follow-up of treatment is necessary in patients with this history and low schooling. A social support network for patients is also indispensable for avoiding unfavorable outcomes.

Resumen: La tuberculosis farmacorresistente (TBFR) representa hoy una grave amenaza para los avances en el control de la tuberculosis (TB) en Brasil y en el mundo. En este estudio, se investigan factores asociados al abandono y al óbito de casos en tratamiento para TBDR, dentro de un centro de referencia de carácter terciario del municipio de Río de Janeiro, Brasil. Se trata de un estudio de cohorte retrospectiva, a partir de los casos notificados en el Sistema de Información de Tratamientos Especiales de Tuberculosis (SITETB), durante el período del 1 de enero de 2012 al 31 de diciembre de 2013. Un total de 257 pacientes fue notificado en el SITETB y comenzó el tratamiento para TBDR. De ese total, 139 (un 54,1%) tuvieron éxito terapéutico como desenlace, 54 (un 21%) abandonaron el tratamiento y un 21 (8,2%) evolucionaron hacia óbito. Tras el análisis de regresión logística multinomial múltiple, la franja de edad por encima de cincuenta años se observó como el único factor de protección al abandono, al mismo tiempo que tener menos de ocho años de escolaridad y reingresar en el sistema educativo tras el abandono fueron considerados como factores de riesgo. Reingreso tras abandono, recidiva e insolvencia indicaron factores de riesgo. Nuestros datos refuerzan la concepción de que el abandono del tratamiento de tuberculosis resistente es un serio problema de salud pública, siendo necesario un adecuado acompañamiento en el tratamiento de pacientes con este historial y con baja escolaridad. Además, una red de apoyo social entorno al paciente es imprescindible para que los desenlaces desfavorables sean evitados.

Mycobacterium kansasii is an opportunistic pathogen and one of the most commonly encountered species in individuals with lung disease. We here report the complete genome sequence of 12 clinical isolates of M. kansasii from patients with pulmonary disease in Brazil.

Abstract The Lagunera Region stands out as the most important melon area in Mexico with an annual area of around 5,000 hectares and a production of 134,000 tons. Production in this region is threatened by imports, pests, diseases, marketing problems, high production costs, lack of financing and increased quality requirements by the self-service stores. The objective of this work was to propose a series of strategies, alliances and business portfolio to improve the competitiveness of the melon production chain in the Comarca Lagunera, Mexico to avoid being displaced by competing regions of the country and abroad. Method : In this work we used the methodology known as "Focus Group". There were 27 participants, of whom 18 were producers of melon, five technicians, two officials from the Ministry of Rural Development of the state government of Coahuila and two representatives of companies supplying agricultural inputs. Two days in several dynamics based on previously elaborated formats. The obtained information was classified having obtained the competitive forces, the strategies, the alliances and the portfolio of businesses. Results : Six strategies were identified for the development of competitiveness, their scope, limitations and the estimated time to be carried out. The strategies were: 1) technical training aimed at obtaining certification in food safety, 2) transfer of the technological package, 3) management of resources to finance and ensure production, 4) direct sale of melon to the retail self-service stores, 5) establish alliances with academic and research institutions and 6) establish alliances with state and federal agencies of the Agricultural Sector. As for the alliances are specific to each strategy, highlighting those with federal and state agencies, Universities and research centers of the agricultural sector; institutions of financing and assurance to the field and chains of stores of self-service. Finally, in the business portfolio it is proposed the creation of 1) a melon marketing management office, 2) a credit union, 3) a professional services rendering agency, and 4) a marketing agency for equipment and supplies. Conclusion : The results allowed to define the main strategies, pacts to be realized and the portfolio of businesses tending to develop the productivity and competitiveness of the melon in the Comarca Lagunera de Coahuila. These results were presented and validated in a meeting of the melon product system of the Comarca Lagunera; however, its implementation will depend on the producers being able to organize and carry out the actions proposed here.

Resumen La Región Lagunera destaca como la zona melonera más importante de México con una superficie anual de alrededor de 5,000 hectáreas y una producción de 134,000 toneladas. La producción de esta región se ve amenazada por las importaciones, plagas, enfermedades, problemas de comercialización, altos costos de producción, falta de financiamiento y mayores exigencias de calidad por parte de las cadenas comerciales de tiendas de autoservicio. El objetivo de este trabajo fue proponer una serie de estrategias, alianzas y portafolio de negocios para mejorar la competitividad de la cadena productiva de melón en la Comarca Lagunera para evitar que sea desplazada por regiones competidoras del país y del extranjero. Método : En este trabajo se utilizó la metodología conocida como "Focus Group" o grupos de enfoque. Se contó con 27 participantes de los cuales 18 fueron productores de melón de la Comarca Lagunera, cinco técnicos, dos funcionarios de la Secretaría del Desarrollo Rural del gobierno del estado de Coahuila y dos representantes de empresas proveedoras de agro insumos. Se trabajó durante dos días en varias dinámicas basadas en formatos previamente elaborados por los responsables del proyecto. La información obtenida se clasificó habiéndose obtenido como resultado las fuerzas competitivas, las estrategias, las alianzas y el portafolio de negocios. Resultados : Se identificaron seis estrategias para el desarrollo de la competitividad, su alcance, limitaciones y el tiempo que se estima para que se lleven a cabo. Las estrategias fueron: 1) capacitación técnica tendiente a obtener la certificación en inocuidad, 2) transferencia del paquete tecnológico, 3) gestión de recursos para financiar y asegurar la producción, 4) venta directa de melón a las cadenas comerciales de tiendas de autoservicio bajo el esquema de contrato, 5) establecer alianzas con instituciones académicas y de investigación y 6) establecimiento de alianzas con dependencias estatales y federales del Sector Agropecuario. En cuanto a las alianzas estas son específicas para cada estrategia destacando aquellas con dependencias federales y estatales; universidades y centros de investigación del sector agropecuario; instituciones de financiamiento y aseguramiento al campo y cadenas de tiendas de autoservicio. Finalmente, en el portafolio de negocios se propuso la creación de 1) una Gerencia comercializadora de melón, 2) una unión de crédito, 3) una agencia técnica de prestación de servicios profesionales y 4) una agencia comercializadora de equipos e insumos. Conclusión : Los resultados permitieron definir las principales estrategias, alianzas a realizar y el portafolio de negocios tendientes a desarrollar la productividad y competitividad del melón en la Comarca Lagunera. Su implementación dependerá de que los productores puedan organizarse y realizar las acciones aquí propuestas.

The main cause of pulmonary tuberculosis (TB) is infection with Mycobacterium tuberculosis (MTB). We aimed to evaluate the contribution of nontuberculous mycobacteria (NTM) to pulmonary disease in patients from the state of Rondônia using respiratory samples and epidemiological data from TB cases. Mycobacterium isolates were identified using a combination of conventional tests, polymerase chain reaction-based restriction enzyme analysis of hsp65 gene and hsp65 gene sequencing. Among the 1,812 cases suspected of having pulmonary TB, 444 yielded bacterial cultures, including 369 cases positive for MTB and 75 cases positive for NTM. Within the latter group, 14 species were identified as Mycobacterium abscessus, Mycobacterium avium, Mycobacterium fortuitum, Mycobacterium intracellulare, Mycobacterium gilvum, Mycobacterium gordonae, Mycobacterium asiaticum, Mycobacterium tusciae, Mycobacterium porcinum, Mycobacterium novocastrense, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium phlei and Mycobacterium holsaticum and 13 isolates could not be identified at the species level. The majority of NTM cases were observed in Porto Velho and the relative frequency of NTM compared with MTB was highest in Ji-Paraná. In approximately half of the TB subjects with NTM, a second sample containing NTM was obtained, confirming this as the disease-causing agent. The most frequently observed NTM species were M. abscessus and M. avium and because the former species is resistant to many antibiotics and displays unsatisfactory cure rates, the implementation of rapid identification of mycobacterium species is of considerable importance.

According to the Organization for Economic Cooperation and Development (2010), Mexico holds the first place worldwide in overweight and second in obesity. The Programa Nacional de Cultura Física y Deporte (2008) seek to raise the number of the country's physically active habitants to 35 million by 2012. The objective of this study is to determine the factors, and their dimension, that influence the decision of practicing physical activity among the residents of Mexico. Using data by the Encuesta Nacional Sobre Uso del Tiempo (2009) , two econometric models were estimated.

Según la Organización para la Cooperación y el Desarrollo Económico (2010), México ocupa el primer lugar mundial en sobrepeso y el segundo en obesidad. El Programa Nacional de Cultura Física y Deporte (2008) busca elevar a treinta y cinco millones el número de habitantes físicamente activos en el país para 2012. El objetivo del presente estudio es la detección y dimensionamiento de los factores que inciden en la realización de actividad física (AF) entre los residentes de México. Utilizando datos de la Encuesta Nacional Sobre Uso del Tiempo (2009), se estimaron dos modelos econométricos.