Objective Evaluate the different perspectives that involve the choice of long-acting reversible contraceptives (LARCs), the issues related to this process and the consequences of deciding one method in the women's in the primary health care (PHC) center in Sousas, a district in Campinas, SP (Brazil). Methods This is an analytical cross-sectional study, it was performed at the PHC in Sousas. Data were collected through the analysis of medical records and interviews with women who live in Sousas and had the insertion of the copper intrauterine device (IUD) (D) from April 2021 to April 2022 or the etonogestrel implant (I) from May to December 2022. The study was approved by the Research Ethics Committee of the Medical Science School at the State University of Campinas (UNICAMP). Results Reason for choosing this LARC: medical (D: 52%; I: 100%), easy adhesion (D: 71%; I: 67%), effectiveness (D: 55%; I: 100%). Indication by health professionals (D: 65%; I: 100%). And improvement of clinical characteristics: mood (D: 77%; I: 67%), body mass index (BMI; D: 52%; I: 33%), and libido (D: 84%; I: 67%). Conclusion It is suggested that women tend to decide between LARCs when guided by their doctor or PHC health professionals, and they select LARCs because of the ease of use and low failure rates. Therefore, this study highlights how LARCs can positively interfere in the aspects that pervade contraception, such as BMI, libido, and mood.

In South America, cutaneous leishmaniasis is caused by several species of the parasite of the genus Leishmania. Here, we describe an imported case of cutaneous leishmaniasis acquired in Peru by a Brazilian patient during her travel to Iquitos. Infection by Leishmania parasites was confirmed by histopathologic examination, and the patient was treated with pentavalent antimony (Pentostam), without clinical response. Molecular typing was performed by sequencing the ribosomal DNA internal transcribed spacer and heat-shock protein 70 gene, which identified the parasites as Leishmania guyanensis. The clinical isolate was similarly susceptible to amphotericin B, pentamidine, and miltefosine as the reference strain, while for pentavalent antimony, this clinical isolate was more susceptible than the reference strain, even though its susceptibility in vitro was still considered low. The patient was then treated with liposomal amphotericin B, with clinical improvement of the lesions.

Background: Erythema nodosum leprosum (ENL) is an immunological inflammatory reaction requiring precise management. Recalcitrant cases, their refractoriness to conventional therapy, and the adverse effects of standard treatments underline the need to explore alternative therapeutic options. Methods: We conducted a retrospective study of five patients treated with secukinumab between January 2023 and January 2025. Results: Patients showed clinical improvement with a reduced ENL frequency, neuritis relief, and corticosteroid sparing. Conclusions: Secukinumab appears to be a promising corticosteroid-sparing option for ENL, with a favorable safety profile. Further studies are required to confirm the efficacy and long-term safety of this treatment regimen.

Introdução: Os contraceptivos de longa duração (LARCs, do inglês Long-Acting Reversible Contraceptives) têm se consolidado como pilares do planejamento reprodutivo moderno. Na Atenção Primária à Saúde (APS), os LARCs são ferramentas fundamentais para o cuidado integral à saúde da mulher. O Programa Mais Médicos Campineiro (PMMC), com a inserção de residentes de Medicina de Família e Comunidade (MFC) na rede de saúde, marcou um novo paradigma no cuidado à saúde da mulher na APS de Campinas (SP) a partir de 2020. Objetivo: Avaliar e comparar indicadores relacionados ao planejamento reprodutivo na APS do distrito de Sousas, em Campinas, e no município, na totalidade, antes e após a introdução de residentes de MFC. Métodos: Os dados foram extraídos do sistema Tabnet-Campinas e da ferramenta de Gestão Estratégica de Materiais e Medicamentos (GEMM). As análises abordaram indicadores relacionados ao planejamento reprodutivo e à aquisição e uso de LARCs na APS. Resultados: Houve um aumento de 300% no uso de LARCs em Sousas, acompanhado por redução nas taxas de gravidez na adolescência, aumento na frequência de consultas de pré-natal e melhora no nível de escolaridade materna em Sousas e no município de Campinas em 2022. Conclusões: Observou-se um aumento expressivo no uso de LARCs na APS e uma melhora significativa nos indicadores de planejamento reprodutivo após o início do PMMC em 2020, evidenciando o impacto positivo da inserção de residentes de MFC no sistema de saúde.

Hyalohyphomycosis and phaeohyphomycosis are groups of mycoses caused by several agents and show different clinical manifestations. We report a case of an immunocompromised patient who presented rare manifestations of opportunistic mycoses: mycetoma-like hyalohyphomycosis on his right foot caused by Colletotrichum gloeosporioides, followed by cutaneous phaeohyphomycosis on his right forearm caused by Exophiala oligosperma. Further to the rarity of this case, the patient's lesion on the foot shows that the clinical aspects of mycetomas could falsely appear in other fungal infections similar to hyalohyphomycosis. We also show that the muriform cells that were seen in the direct and anatomopathological examination of the skin are not pathognomonic of chromoblastomycosis, as observed in the lesion of the patient's forearm.