Resumen El objetivo de esta investigación fue analizar los retos y oportunidades del turismo rural en Latinoamérica, frente a la COVID-19. Se desarrolló una revisión sistemática de literatura (2020-2021) para aportar un panorama global de la situación. Los datos se contrastaron mediante un estudio de caso múltiple. Se analizó el caso del altiplano central mexicano a partir de las estrategias de adaptabilidad desarrolladas por los emprendimientos de turismo rural del territorio; de Colombia mediante una propuesta de redefinición resiliente del corregimiento de Vegalarga, zona rural en conflicto; de Brasil a partir de la articulación de una estrategia de turismo rural consciente, y de Argentina a través del análisis de las políticas públicas orientadas a la reactivación turística. Dichas estrategias de adaptación del turismo rural a la COVID-19 son resultado de las configuraciones sociales, económicas y políticas de cada contexto. Es posible identificar resultados heterogéneos y cambiantes que serán el antecedente de la redefinición del turismo rural ante la pandemia. El turismo rural es una opción de dinamización económica pospandemia, en la medida que atienda las necesidades de ocio y recreación en contextos de restricción económica, disminución de la movilidad e inseguridad psicológica provocados por la pandemia de COVID-19. El turismo rural puede contribuir a resignificar el sentido de viajar, orientándose a prácticas sostenibles y mejorando las condiciones de vida de las comunidades rurales.

Abstract The aim of this research was to analyze the challenges and opportunities of rural tourism in Latin America, in the face of COVID-19. A systematic literature review was developed (2020 to 2021) to provide a global overview of the situation. The data were contrasted by means of a multiple case study. The case of the Mexican central highlands was analyzed based on the adaptability strategies developed by rural tourism enterprises in the territory; the case in Colombia through a proposal for a resilient redefinition of the Vegalarga district, a rural area in conflict; the case in Brazil through the articulation of a mindful rural tourism strategy; and the one in Argentina through the analysis of public policies aimed at reactivating tourism. These strategies for adapting rural tourism to COVID-19 are the result of the social, economic, and political configurations of each context. It is possible to identify heterogeneous and changing results that will be the background for the redefinition of rural tourism in the face of the pandemic. Rural tourism is an option for post-pandemic economic revitalization, to the extent that it meets the needs for leisure and recreation in the context of economic restrictions , decreased mobility and psychological insecurity, caused by COVID-19. Rural tourism can contribute to redefining the meaning of traveling, focusing on sustainable practices, and improving the living conditions of rural communities.

Resumen El Paleógeno del Cinturón Plegado de San Jacinto (CPSJ) corresponde a una sucesión sedimentaria heterolítica, lo cual ha causado que el registro de microfósiles sea poco estudiado, particularmente para el Paleógeno Inferior. Este es el caso de la Formación San Cayetano, que por medio de las asociaciones de foraminíferos, ha sido interpretada como una unidad de edad Paleoceno-Eoceno temprano, y depositada en un ambiente de tipo turbidítico. Sin embargo, los niveles donde se han reportado los foraminíferos son intervalos discretos y un incremento en los estudios sedimentológicos y paleontológicos (macrofósiles), ha causado que tanto el rango cronoestratigráfico como los ambientes de depositación de la Formación San Cayetano vengan siendo objeto de debate. Teniendo en cuenta que las asociaciones de foraminíferos en esta unidad corresponden principalmente a formas bentónicas aglutinadas, se presenta el estudio taxonómico detallado de los especímenes más representativos en varias secciones que comprenden sedimentitas de la Formación San Cayetano. Las morfoespecies de foraminíferos descritas en este trabajo corresponden a especímenes poco diversos, con abundancias y preservaciones moderadas, los cuales comprenden principalmente formas aglutinantes tubulares y multiseriales. Aunque los taxones descritos representan en buena medida al tipo de foraminíferos reportados para la Formación San Cayetano, abarcando un intervalo de tiempo Paleoceno tardío-Eoceno temprano, algunos de los taxones referidos en este trabajo, como Aschemocella subnodosiformis, Bathysiphon eocanicus, Budhashevaella trinitatensis, Nothia lattissima o Reticulophragmoides jarvisi, ayudarían a restringir el rango de edad del nivel donde se encuentren. Igualmente, el tipo de foraminíferos encontrados confirma la interpretación previa de ambientes turbidíticos (flysch-type foraminiferal assemblages) o en su defecto, ambientes con una alta inestabilidad en el substrato. Por ende, estos resultados refuerzan la idea de que a futuro se clarifiquen las relaciones estratigráficas de los niveles de foraminíferos, con la de aquellos intervalos que han sido interpretados como depositados en ambientes proximales.

Abstract The San Jacinto Fold Belt comprises a heterolithic succession, particularly in the Lower Paleogene, which might hamper the presence of diagnostic fossils. This case is notorious in the San Cayetano Formation, which strata have been interpreted as deposited in turbiditic setting and presents a late Paleocene-Early Eocene age using foraminiferal assemblages. However, the presence of foraminifers in the San Cayetano Formation is scattered, mostly constituted by benthic agglutinated assemblages, and the input of new data (sedimentology, macrofossils) have increased the discussion about the age and depositional context of that unit. Considering these issues, a detailed taxonomic study of the foraminiferal assemblages that define the Lower Paleogene in the San Jacinto Fold Belt was elaborated, using material of several sections of the San Cayetano Formation. Despite the agglutinated foraminifers present low diversity values, these have several abundance and preservation degrees, comprising tubular and multiserial agglutinated forms. Though some of the taxa have been referred in the San Cayetano formation, some of the identified species such as Aschemocella subnodosiformis, Bathysiphon eocanicus, Budhashevaella trinitatensis, Nothia lattissima or Reticulophragmoides jarvisi might refine the age proposal of late Paleocene-early Eocene. Furthermore, the foraminifers can be interpreted as flysch-type assemblages, or also associated with highly unstable substrates, aspects previously reported for this unit. In view of the most recent studies on the San Cayetano Formation, our contribution reinforces the importance of integrating paleontological and sedimentological data in incoming projects. This, in order of segregating the possible turbiditic settings of this unit from those proposed like more proximal.

ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.

ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.

Resumen El conocimiento sobre la riqueza y la distribución de las plantas epifítas vasculares es aún incompleto en muchas áreas de México. Un ejemplo es la región terrestre prioritaria (RTP) Cerros Negro-Yucaño, que se ubica en el noroeste del estado de Oaxaca y pertenece a la región mixteca alta (Ñuu Savi Sukun, Ñuu vixi). Con base en la revisión de material de herbario en 12 colecciones institucionales mexicanas y en la recolección de especímenes en algunas localidades, principalmente cubiertas por bosque de encino, en 17 de los 18 municipios que incluye la RTP, se compilo un listado de las angiospermas epífitas. Se registró la presencia de 40 especies, distribuidas en 13 géneros y cinco familias; 28 taxa son endémicos de México y tres de ellos se conocen solamente de Oaxaca. Los géneros Tillandsia (18 spp.) y Peperomia (4) fueron los mejor representados en el área. El bosque de encino fue el tipo de vegetación en el cual se encontraron más epífitas (32 spp.) y también el intervalo altitudinal de 1 900 a 2 100 m (19 spp.). Plantas en floración de Artorima erubescens, Laelia albida, L. furfuracea y Prosthechea karwinskii, son utilizadas por pobladores de la región como ornamentales, durante las celebraciones religiosas de Día de Muertos y Semana Santa. Este impacto humano podría representar una amenaza para las poblaciones silvestres de estas especies en el futuro.

Abstract The knowledge on richness and distribution of epiphytic vascular plants is still incomplete in many areas of Mexico. An example is the terrestrial priority region (RTP) Cerros Negro-Yucaño, which is located in the Northwest portion of Oaxaca and belongs to the Mixteca Alta Region (Ñuu Savi Sukun, Ñuu Vixi). Based on herbarium material revision of 12 Mexican institutional collections and the collection of specimens in some localities, mainly covered by oak forest, in 17 of the 18 municipalities included in the RTP, we compiled a list of epiphytic angiosperms. The presence of 40 species, distributed in 13 genera and five families was recorded; 28 taxa are endemic to Mexico and three of them are only known from Oaxaca. The genera Tillandsia (18 spp.) and Peperomia (4) were the best represented genera in the area. Oak forest was the type of vegetation in which the most of the epiphytes were found (32 spp.), and also the altitudinal range between 1 900 and 2 100 m (19 spp.). Flowering plants of Artorima erubescens, Laelia albida, L. furfuracea, and Prosthechea karwinskii are used by the local people as ornamentals during the religious celebrations of Day of the Dead (Mexico) and Holly Week. This human impact might be a threat to the wild populations of these species in the future.

Introduction: Attention deficit hyperactivity disorder (ADHD) has a worldwide prevalence of 5%, and most of medical consultations to children with the diagnosis take place in Primary Care settings. It would be necessary for physicians of the Rural and Urban-Marginal Health Service (SERUM) in Peru to have sufficient knowledge about the diagnosis and management of this disorder for its timely referral to the specialist. Objectives: To determine the knowledge level that SERUM primary care physicians have regarding diagnosis, management and prognosis of ADHD. Material and Methods: This is a descriptive, observational and transversal study, based on the application of a survey instrument, specifically designed for the study of ADHD, and revised by the Peruvian Association of Professionals. Results: From a total of 550 surveys applied, 63.5% (349) met the inclusion criteria. It was found that 80.5% of these probands had a high level of general knowledge about ADHD, but only a 16.9% has a similar knowledge level regarding diagnosis, and 73.1%, an intermediate level. Regarding treatment, 56.2% of the sample had a high and 39.8%, an average knowledge level.Conclusions: SERUM-associatedprimary care physicians in Lima have a high knowledge level about general aspects of ADHD as they consider a combined treatment as the management of choice, and give importance to the prognosis of the non-treated patient. However, most of them do not base their diagnosis on DSM-5 or ICD-10 criteria, and do not identify first-line pharmacological agents for the management of the disorder. The need to improve this aspects is emphasized.

Introducción: El trastorno por déficit de atención con hiperactividad (TDAH), exhibe una prevalencia mundial del 5% y la mayoría de las consultas médicas tienen lugar en clínicas de Atención Primaria. En tal contexto, se plantea la necesidad de que los médicos del Servicio Rural y Urbano Marginal de Salud (SERUM) conozcan suficientemente aspectos del diagnóstico y manejo de este trastorno, para su oportuna derivación al especialista. Objetivos: Determinar el nivel de conocimiento que tienen los médicos serumistas en relación al diagnóstico, manejo y pronóstico del TDAH. Material y Métodos: Estudio descriptivo, observacional y transversal basado en la aplicación de una encuesta a médicos serumistas, revisada por la Asociación de Profesionales Peruanos para el estudio del Trastorno por Déficit de Atención e Hiperactividad. Resultados. De un total de 550 encuestas, 63,5% (349) cumplieron los criterios de inclusión. Se encontró que el 80,5 % de estos probandos tenían un alto nivel de conocimiento general sobre el TDAH. Sin embargo, sólo el 16,9% mostró un nivel similar en relación al diagnóstico y el 73,1% alcanzó un nivel de conocimiento medio. En relación al tratamiento, 56,2 % de la muestra tuvo un nivel alto y 39,8 %, un nivel medio de conocimiento. Conclusiones: Los médicos serumistas encuestados en Lima muestran un alto nivel de conocimiento global en relación al TDAH, consideran apropiadamente el tratamiento mixto de elección y dan importancia al pronóstico del paciente no tratado. La mayoría, sin embargo, no basa su diagnóstico en los criterios del DSM5 o CIE 10 y no identifican fármacos de primera línea para el manejo del trastorno. Se postula la necesidad de mejorar estos aspectos

Este trabalho tem como objetivo avaliar fatores considerados de risco para adquirir leishmaniose cutânea em Salta, área de maior transmissão da Argentina. Aplicou-se um estudo de caso-coorte com observações entre junho de 1989 e dezembro de 1992. Aos casos e aos controles selecionados se realizou: a) um questionário sócio-demográfico; b) descrição das características da vivenda e peridomicílio; c) um exame físico de pele e mucosa nasal e bucal; d) intradermorreação de Montenegro. A análise multivariada mostrou um risco significativo para fatores extradomiciliares (realizar atividades de vaqueira, dormir no lugar de trabalho, ir caçar) e domiciliares (dormir fora do quarto, presença de três ou mais suínos no quintal da casa e existência de janelas sem fechaduras). Esta associação permitiu pela primeira vez em Salta (Argentina), identificar fatores de risco vinculados com a transmissão de leishmaniose na unidade domiciliária.

The objective of this work was evaluate risk factors for acquiring cutaneous leishmaniasis in Salta, the region with the greatest indices of transmission in Argentina. A Case-cohort study was realized from June 1989 to December 1992. The procedures performed on cases and controls included: a) socio-demographic questionnaire; b) domestic and peridomestic environment description; c) physical exam of skin and nasal and oral mucosal; d) Montenegro Skin Test. Multivariate analysis showed a significant risk for factors outside the home (cattle management, hunting, sleeping at the work place) and while at home (sleeping outside of the bedroom, presence of three or more pigs in the yard and windows that cannot be locked in the closed position). This association allowed the identification of risk factors linked to the transmission of leishmaniasis in the home for the first time in Salta (Argentina).

Labio y paladar hendidos son malformaciones frecuentes en nuestro país, cuya incidencia va en aumento proporcionalmente a la población, presentamos en este articulo su etiología, anatomía patológica, incidencia, examen clínico y reporte de un caso.

Clift lip and palate are congenital irregularities often in our country , the incidence of this kind of lession is going up year by year, we present here in this article the ethiology, pathological anatomy, clinical research and the report of a case.