Visceral leishmaniasis (VL) is an anthropozoonosis with high prevalence and incidence in the Northeastern region of Brazil. This study aimed to determine whether people living near the Mossoró River in the city of Mossoró, Rio Grande do Norte, have knowledge of VL and to characterize the environmental properties of this region. Questionnaires were administered to 478 residents in three neighborhoods near the Mossoró River, addressing the population’s knowledge about VL and environmental characteristics. Most survey participants were female, with ages between 18 and 40 years, 53.8% had completed primary education, and 61.5% owned pet dogs (p < 0.05). The majority (95.9%) showed little knowledge about the characteristics inherent to sandflies, and 85.3% were unaware of the environments preferred by this vector (p < 0.05). Sewage from the homes of respondents was mainly dumped into the river (44.6%), and 76.6% of the respondents complained about the accumulation of garbage in the streets (p < 0.05). The association between education and knowledge about the transmission of VL and preferred vector locations was statistically significant (p < 0.05). The lack of knowledge in the population about VL and the residential environment indicates a risk of maintaining sand fly habitats and hence disease transmission.

Introduction: An awareness of visceral leishmaniasis (VL) is necessary to encourage the population to participate in preve ntion and control in collaboration with more effi cient, centrally organized health programs. The aim of this study was to evaluate the awareness of the riverside population regarding VL and the association between awareness and the prevalence of canine visceral leishmaniasis (CVL). Methods: In total, 71 people living in riverside areas in the City of Mossoró in State of Rio Grande do Norte participated of the study, and 71 dogs were tested for CVL by polymerase chain reaction (PCR). Association analysis of several variables related to knowledge of the riverside population regarding CVL positivity was performed, yielding odds ratios (OR) and 95% confi dence intervals (CI), and signifi cance was determined using chi-square (χ2) and Fisher's exact tests. Results: Among individuals whose dogs tested positive for CVL, 60% did not know the cure for CVL, and these subjects were three times more likely to have a dog test positive for CVL than those who were aware the cure for CVL. Knowledge of CVL cure was the only variable that remained in the logistic model after the successive removal of variables, with an adjusted OR of 3.11 (95%CI: 1.1-8,799; p=0.032). Conclusions: Insuffi cient awareness regarding VL in riverside areas with CVL-positive dogs was associated with increased rates of canine infection, which suggests that changes in habits and the adoption of attitudes and preventive practices may contribute to the control and prevention of this disease. This study reinforces the need to invest in better health education programs regarding VL.

Background: Thyroid hormones have important effects on the cardiovascular system, of which the main ones are the increase in the heart response to the autonomic sympathetic nervous system. Heart rate variability is a non-invasive method of assessing autonomic heart modulation, thus being an important form of evaluation in patients with thyroid dysfunctions. This study aimed to report electrocardiographic and heart rate variability data of a dog with hypothyroidism that presented a parasympathetic dysfunction.Case: A 7-year-old female Dalmatian dog was admitted for clinical evaluation in Fortaleza, Brazil. According to the owner, she had been apathetic for a year, had gained weight, always had a sad expression, and her hair was generally brittle and opaque. On physical examination, skin lesions were observed at the end of the spine, extending to the tail region, with the latter showing total alopecia. Low T4 levels confirmed the diagnosis of primary hypothyroidism. Then, a 24-h Holter monitoring was performed, which showed that the animal had sinus arrhythmia associated with moments of second-degree sinoatrial block and rare moments of sinus tachycardia. In addition, moments of premature multifocal ventricular extrasystoles and 1st-degree atrioventricular block were observed. Based on the Holter results, heart rate variability (HRV) was calculated. Regarding the HRV in the frequency domain, 32.16 was obtained in the low frequency (LF) band, 67.84 in the high frequency (HF) band, and the LF / HF ratio was 0.46, with a total power of 5205. As for the HRV in the time domain, RMSSD was 117, pNN50 was 62.64 and SDNN was 384. This showed an increase in the parasympathetic activity of the heart and, due to this increased activity, a second-degree sinoatrial block occurred, which is a sinus function disturbance resulting from the exacerbated parasympathetic activity.Discussion: Beta-adrenergic receptors have their expression and activity altered by thyroid hormones. The sympathetic stimulation on the heart through the activation of these receptors originates a positive inotropic, lusitropic, dromotropic and chronotropic effect. Therefore, in the absence of thyroid hormones, there is a decrease in this stimulation, thus allowing a preponderant parasympathetic tone. In the present report, the increase in the parasympathetic tonus, observed in hypothyroidism, resulted in a reduction in the frequency of sinus firing, slowing of intranodal and sinoatrial conduction, and shortening of the effective refractory period, a combination of factors that led to decreased HR observed in the Holter monitoring. Previous studies have shown that thyroid hormones increase sympathetic activity, mainly in the heart, since they do not act by increasing the production or release of catecholamines, but rather increasing catecholamine response on the heart, due to a positive regulation of Ca2+-ATPase channels of the sarcoplasmic reticulum and beta1-adrenergic receptors. Thus, the observed result was already expected, because in hypothyroidism there is a decrease in these hormones that increase the sympathetic activity on the heart and so, the parasympathetic tone was very evident. The study of heart rate variability allows the simple assessment of the autonomic nervous system imbalance, and may be extremely important in the follow-up of diseases that affect this balance, such as hypothyroidism. Hence, more studies are required to verify the effect of such diseases on heart rate variability, aiming to define associations between the diseases and the alterations, as well as to define parameters of normality for such examinations.

Objetivo: A Leishmaniose Visceral é transmitida pela Lutzomyia longipalpis. A cidade de Mossoró, no Nordeste brasileiro, tem alta prevalência da doença. Além disso, regiões próximas ao rio Mossoró, propícias para a presença do vetor, ainda não têm registro sobre fatores de risco para a doença, se fazendo necessário um estudo epidemiológico dessas áreas. Portanto, este trabalho objetivou avaliar a densidade de flebotomíneos e a influência das variáveis ambientais sobre essa fauna em áreas às margens do rio Mossoró. Métodos: Foi realizado levantamento entomológico com armadilhas luminosas tipo CDC e a influência da temperatura, umidade, pluviosidade e velocidade do vento sobre os flebotomíneos foi analisada. Resultados: Observou-se a presença de flebotomíneos durante todo o ano, sendo a maior quantidade (71,3%) nos peridomicílios. Do total de flebotomíneos capturados, 92,2% eram da espécie L. Longipalpis. Em relação ao sexo, a quantidade de insetos machos superou a quantidade de fêmeas em 62,4%. Comparando a densidade vetorial a fatores ambientais, percebe-se que as altas temperatura e umidade, a presença de chuva e a baixa velocidade dos ventos tornam o ambiente propício. Conclusão: Nota-se a importância de se caracterizar essas áreas próximas ao rio Mossoró, com estudos entomológicos, pois essas pesquisas são relevantes na elaboração de políticas de vigilância e controle da doença.

A cidade de Mossoró, no Nordeste brasileiro, tem alta prevalência da doença. Além disso, regiões próximas ao rio Mossoró, propícias para a presença do vetor, ainda não têm registro sobre fatores de risco para a doença, se fazendo necessário um estudo epidemiológico dessas áreas. Portanto, este trabalho objetivou avaliar a densidade de flebotomíneos e a influência das variáveis ambientais sobre essa fauna em áreas às margens do rio Mossoró. Métodos: Foi realizado levantamento entomológico com armadilhas luminosas tipo CDC e a influência da temperatura, umidade, pluviosidade e velocidade do vento sobre os flebotomíneos foi analisada. Resultados: Observou-se a presença de flebotomíneos durante todo o ano, sendo a maior quantidade (71,3%) nos peridomicílios. Do total de flebotomíneos capturados, 92,2% eram da espécie L. Longipalpis. Em relação ao sexo, a quantidade de insetos machos superou a quantidade de fêmeas em 62,4%. Comparando a densidade vetorial a fatores ambientais, percebe-se que as altas temperatura e umidade, a presença de chuva e a baixa velocidade dos ventos tornam o ambiente propício. Conclusão: Nota-se a importância de se caracterizar essas áreas próximas ao rio Mossoró, com estudos entomológicos, pois essas pesquisas são relevantes na elaboração de políticas de vigilância e controle da doença.