A leishmaniose tegumentar americana é doença infecciosa da pele e mucosa, cujo agente etiológico é um protozoário do gênero Leishmania. Seu tratamento é desafio porque as drogas disponíveis apresentam elevada toxicidade, e nenhuma delas é bastante eficaz. A recidiva, a falha terapêutica em pacientes imunodeprimidos e a resistência ao tratamento são fatores que motivam a busca de uma droga ideal.

Introduction: The treatment of mucosal leishmaniasis (ML) is difficult due to the toxicity and route of administration of standard drugs. Miltefosine is an oral agent used for leishmaniasis treatment; however, no data exist regarding its use for ML in Brazil. In this study, we aimed to evaluate the efficacy of miltefosine for ML treatment compared to that of pentavalent antimonial in a pilot study. Methods: We performed a randomized clinical trial with two parallel groups. The tested intervention consisted of miltefosine 1.3-2 mg/kg/day (two capsules) for 28 days or intravenous 20 mg SbV/kg/day of meglumine antimoniate (N-MA) for 30 days. The final endpoint was defined as complete healing of the lesion four years after treatment. We also analyzed an early endpoint at 90 days after treatment. Results: Forty patients were included in this study: each experimental group comprised 20 patients. Applying a multivariate model in an intention-to-treat analysis, we observed that patients treated with miltefosine had a cure probability 2.08 times greater (95% confidence interval [CI] = 1.03-4.18) than those treated with N-MA at 90 days after treatment. At the final endpoint, we observed no differences in cure probability between miltefosine and N-MA (relative risk = 0.66; 95% CI = 0.33-1.32). With respect to adverse reactions, significant differences between groups were related to gastrointestinal effects, which were more frequent in the miltefosine group. Conclusions: Miltefosine may be an interesting alternative for treating ML because of its oral administration and cure rate after long-term follow-up.

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Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.

Darcy Ribeiro nunca escondeu de ninguém que acalentava o sonho de ver construída a sede definitiva de sua Fundação no campus da Universidade de Brasília (UnB). Para tanto, contanto com o apoio de Oscar Niemeyer, encomendou o projeto ao arquiteto João Filgueiras Lima. A rigor, Darcy Ribeiro pediu ao Lelé "apenas" o "projeto de uma biblioteca" para acolher o seu acervo de livros, mobiliário particular e a rica coleção de arte plumária de sua primeira mulher, Berta Ribeiro. De 1996 a 2010, Lelé desenvolveu o projeto que, com o tempo e a colaboração do próprio Darcy, foi sendo aperfeiçoado, de modo a refletir claramente o pensamento dos dois criadores. Nasceu de tal parceria a sede da Fundação Darcy Ribeiro com o "beijódromo", erguida no coração da UnB. Uma edificação circular em dois pavimentos, com 32,20m de diâmetro interno e 37m de diâmetro de cobertura, tal como uma tenda de circo (ou uma maloca indígena, como preferia Darcy), que se lança para o alto em sua parte central e acolhe um espaço circular ajardinado, de 12m de diâmetro e pé-direito duplo. Trata-se de uma obra singular. Não apenas um memorial. Lelé soube desenhar o sonho de Darcy. Uma "espaçonave" que descansa suavemente em solo universitário, contendo e preservando o pensamento de Darcy Ribeiro.