ABSTRACT Background: Domiciliation by Triatoma sordida is a public health concern in South America. This study aimed to evaluate the morphometric changes in the domestic and peridomestic populations of T. sordida. Methods: Specimen hemelytra were mounted, digitized, and processed for geometric morphometric analyses. Results: The specimens captured in houses were smaller than those captured in peridomiciles. A large size reduction effect was observed in female peridomicile populations compared with female house populations. Conclusions: T. sordida house populations were smaller than peridomestic populations. Wing geometric morphometry can be used as a tool to indicate T. sordida domiciliation. Background America T Methods mounted digitized analyses Results peridomiciles Conclusions domiciliation

ABSTRACT Background: Chagas disease (CD) is caused by Trypanosoma cruzi and transmitted by triatomines. Historical information from the 20th century demonstrates T. cruzi records in the metropolitan region of Salvador (MRS), the third largest urban agglomeration in the Brazilian Northeast and the eighth largest in Brazil, an area with intense migratory activity from CD-endemic regions. Therefore, this study aimed to evaluate CD indicators (prevalence and mortality) in the MRS. Methods: A mixed ecological and descriptive study was conducted using secondary data. We analyzed data from 2008 to 2015: deaths due to CD, self-reported cases of CD, and blood donors that were non-negative for T. cruzi infection. Results: São Francisco do Conde was one of the municipalities with the highest mortality rates due to CD. The seroprevalence rates varied by year and municipality; those with the highest values were 2008: Vera Cruz, 2009: Mata de São João, 2010: Dias D'Ávila, 2011 and 2015: São Francisco do Conde, 2012: São Sebastião do Passé, and 2013 and 2014: Pojuca. Spatial correlations between the municipalities were not detected. Conclusions: We conclude that CD is present in the MRS. The indicators analyzed in the MRS are below-state-level data. Given the importance of indicator analysis for the surveillance and control of CD at the state and national levels, it is important to strengthen the surveillance program at the municipal level, including the regions classified as low risk for T. cruzi vector transmission. Background (CD triatomines th T MRS, , (MRS) Brazil CDendemic endemic Therefore prevalence Methods 200 2015 selfreported self reported nonnegative non negative infection Results municipality Cruz 2009 João 2010 DÁvila, DÁvila D Ávila, Ávila D'Ávila 201 2012 Passé 2014 Pojuca detected Conclusions belowstatelevel below level levels transmission (MRS 20 2

RESUMO OBJETIVO Avaliar o seguimento das crianças com diagnóstico de surdez na triagem auditiva neonatal e fatores de risco para deficiência auditiva. MÉTODOS Estudo quantitativo, transversal e retrospectivo para avaliação de fatores associados à perda auditiva e o seguimento dos casos de crianças diagnosticadas com disfunção audiológica, por meio da análise de prontuários eletrônicos de 5.305 crianças encaminhadas a um Centro Especializado em Reabilitação Tipo I, no período de janeiro/2016 a fevereiro/2020, na cidade de Manaus, Amazonas. O estudo estatístico utilizou o teste qui-quadrado de Pearson e por regressão logística binária nos quais foram obtidos odds ratio com intervalos de confiabilidade de 95%. RESULTADOS Das 5.305 crianças encaminhadas para realização do reteste da orelhinha, 366 (6,9%) falharam no reteste. Prosseguiram no estudo as crianças com diagnóstico de perda auditiva neurossensorial, totalizando 265 (72,4%). Permanecendo, no final da pesquisa, apenas 58 (21,9%) crianças, destas 39 receberam aparelho auditivo até o presente estudo; e 16 (41%) já tinham indicação cirúrgica para implante coclear, sendo que apenas três (18,7%) haviam realizado a cirurgia. Dentre os fatores de risco para deficiência auditiva encontramos 2,6 vezes mais chance de falha no reteste da orelhinha naquelas crianças que tinham história familiar de perda auditiva e internação em UTI. CONCLUSÕES Embora o fluxo de triagem alcance boa parte dos nascidos vivos, as taxas de evasão durante o processo são altas, portanto, as características socioeconômicas e geográficas de regiões como a Amazônia devem ser consideradas como fatores relevantes à evasão dos programas de reabilitação dessas crianças. Foi possível identificar que a internação em UTI neonatal e o histórico familiar de perda auditiva presentes nas investigações compõem os principais e mais importantes fatores para alteração dos retestes da orelhinha.

ABSTRACT OBJECTIVE To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss. METHODS Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson’s chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%. RESULTS Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay. CONCLUSION Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.

ABSTRACT OBJECTIVE To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss. METHODS Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson’s chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%. RESULTS Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay. CONCLUSION Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.

RESUMO OBJETIVO Avaliar o seguimento das crianças com diagnóstico de surdez na triagem auditiva neonatal e fatores de risco para deficiência auditiva. MÉTODOS Estudo quantitativo, transversal e retrospectivo para avaliação de fatores associados à perda auditiva e o seguimento dos casos de crianças diagnosticadas com disfunção audiológica, por meio da análise de prontuários eletrônicos de 5.305 crianças encaminhadas a um Centro Especializado em Reabilitação Tipo I, no período de janeiro/2016 a fevereiro/2020, na cidade de Manaus, Amazonas. O estudo estatístico utilizou o teste qui-quadrado de Pearson e por regressão logística binária nos quais foram obtidos odds ratio com intervalos de confiabilidade de 95%. RESULTADOS Das 5.305 crianças encaminhadas para realização do reteste da orelhinha, 366 (6,9%) falharam no reteste. Prosseguiram no estudo as crianças com diagnóstico de perda auditiva neurossensorial, totalizando 265 (72,4%). Permanecendo, no final da pesquisa, apenas 58 (21,9%) crianças, destas 39 receberam aparelho auditivo até o presente estudo; e 16 (41%) já tinham indicação cirúrgica para implante coclear, sendo que apenas três (18,7%) haviam realizado a cirurgia. Dentre os fatores de risco para deficiência auditiva encontramos 2,6 vezes mais chance de falha no reteste da orelhinha naquelas crianças que tinham história familiar de perda auditiva e internação em UTI. CONCLUSÕES Embora o fluxo de triagem alcance boa parte dos nascidos vivos, as taxas de evasão durante o processo são altas, portanto, as características socioeconômicas e geográficas de regiões como a Amazônia devem ser consideradas como fatores relevantes à evasão dos programas de reabilitação dessas crianças. Foi possível identificar que a internação em UTI neonatal e o histórico familiar de perda auditiva presentes nas investigações compõem os principais e mais importantes fatores para alteração dos retestes da orelhinha.

ABSTRACT Background: Neglected tropical diseases are a growing threat to global health, and endemic Chagas disease has emerged as one of the most important health problems in America. The main strategy to prevent Trypanosoma cruzi transmission is chemical control of vectors. This study presents a descriptive analysis of synanthropic triatomines before and after the implementation of a vector-control program in Bahia, Brazil. Methods: Descriptive analysis and geospatial statistics were performed on triatomine data, (1) the relative abundance and (2) proportional spatial distribution, from Bahia during two periods: (A) 1957 to 1971 and (B) 2006 to 2019. Results: We observed a decrease in the relative abundance of Panstrongylus megistus (A: n=22.032, 61.9%; B: n=1.842, 1.0%) and Triatoma infestans (A: n=1.310, 3.7%; B: n=763, 0.43%), as well as an increase in the relative abundance of T. sordida (A: n=8.314, 23.4%, B: n=146.901, 81.6%) and T. pseudomaculata (A: n=894, 2.5%, B: n=16.717, 9.3%). Conclusions: Our results indicate a clear reduction in the occurrence of P. megistus and T. infestans (last record in 2015) and an increase in the relative abundance and geographical distribution of T. sordida and T. pseudomaculata after 40 years of the vector-control program. The high frequency of other triatomine species in the municipalities of the state of Bahia and their abundance in recent years highlight the need to reinforce permanent entomological surveillance actions to prevent Chagas disease.

Abstract Gangliocytic paragangliomas are infrequent neuroendocrine tumors, usually of benign course and in the vast majority without any symptoms reported. We present the case of a young, previously healthy patient, who consults for abdominal pain and upper gastrointestinal bleeding. Through an endoscopy of the upper digestive tract, a pedicle lesion is evidenced in the second portion of the duodenum. We decided to perform a medium laparotomy and duodenectomy with resection of pedicle duodenal tumor. The results of the histological and immunohistochemical study were compatible with a duodenal gangliocytic paraganglioma. After the procedure, the patient presents adequate recovery without evidence of recurrence in the follow-up.

Resumen Los paragangliomas gangliocíticos son tumores neuroendocrinos infrecuentes del sistema gastrointestinal, generalmente de curso benigno y en la gran mayoría de los casos asintomáticos. Presentamos el caso de un paciente joven, previamente sano, quien consulta por dolor abdominal y hemorragia de vías digestivas altas. En la endoscopia de vías digestivas altas se evidencia una lesión pediculada en la segunda porción del duodeno. Se decide realizar laparotomía mediana y duodenectomía con resección del tumor duodenal pediculado. Los resultados del estudio histológico e inmunohistoquímico fueron compatibles con paraganglioma gangliocítico duodenal. Posterior al procedimiento presenta adecuada recuperación, sin evidencia de recidiva en el seguimiento.

Objective to analyze the adherence of nursing professionals to preventive measures of infection by peripheral venous catheter. Methods a cross-sectional study carried out in an adult intensive care unit with 47 nursing professionals. Results statistically relevant measures for adherence to infection prevention were identified, such as double checking of drugs, verification of medication prior to administration, certification of allergy in patients prior to administration, separation of material prior to procedure, length of stay of the catheter for less than 72 hours, fixation exchange in 24 hours, actions related to the handling of the injection ports and connectors, and access salinization after administering solutions through the catheter. These measures were not yet fully added in the professional routines of the research subjects, despite professionals had stated they knew them (97.9%) and that the measures contributed to preventive actions (100.0%). Conclusion the investigated nursing professionals showed low adherence to the preventive measures of infection in the peripheral venous catheters.

Objetivo analisar a adesão dos profissionais de enfermagem às medidas de prevenção de infecção por cateter venoso periférico. Métodos estudo transversal, realizado em Unidade de Terapia Intensiva adulto, com 47 profissionais de enfermagem. Resultados identificaram-se medidas estatisticamente relevantes para adesão à prevenção de infecções, como dupla checagem dos fármacos, verificação de medicamento antes de administrar, certificação de alergia em pacientes antes da administração, separação do material antes do procedimento, tempo de permanência do cateter inferior a 72 horas, troca da fixação em 24 horas, ações relacionadas ao manuseio das portas de injeção e conectores e salinização do acesso após administrar soluções pelo cateter. Verificou-se que essas medidas ainda não foram completamente adicionadas nas rotinas profissionais dos sujeitos da pesquisa, a despeito de terem afirmado conhecê-las (97,9%) e contribuir com ações preventivas (100,0%). Conclusão os profissionais de enfermagem investigados apresentaram baixa adesão às medidas preventivas de infecção nos cateteres venosos periféricos.

Abstract INTRODUCTION: Chagas disease (CD) affects 5.7-7.0 million individuals worldwide, and its prevalence reached 25.1% in the state of Bahia, Brazil. There is an association between the prevalence of CD, the socioeconomic status of the population, and the risk of re-emergence due to non-vectorial transmission, such as blood transfusion. This study determined the seroprevalence of T. cruzi infection among blood donors in the state of Bahia, located in northeastern Brazil, and their epidemiological profile during a 10-year period. METHODS: We performed a descriptive cross-sectional study involving a database review. Data were collected from patients with non-negative results for T. cruzi infection during a 10-year period. RESULTS: A total of 3,084 (0.62%) samples were non-negative for T. cruzi infection in an initial serological screening, and 810 (0.16%) samples were non-negative in the second screening. The correlation between infection and age (30 years or older) and between infection and lower educational level (12 years or less) in the first and second screening was statistically significant. The seroprevalence of T. cruzi infection was higher in men in the first screening. In addition, 99.52% of the municipalities of Bahia had at least one case of CD. Livramento de Nossa Senhora and Salvador presented the highest disease prevalence and recurrence, respectively. CONCLUSIONS: The seroprevalence of T. cruzi infection in these populations was lower than that found in other studies in Brazil but was comparatively higher in densely-populated areas. The demographic characteristics of our population agreed with previous studies.

Costuma-se dizer que os espectadores das tragédias já conheciam os mitos nelas dramatizados. Mas o que conheciam realmente dessas histórias? As relações entre mito e tragédia são tão lineares assim? O presente artigo procura justamente questionar essa linearidade, evidenciando o tipo de adaptações, cortes e escolhas sofrido pelo material mítico na sua passagem à cena. A tragédia restringe-se a certos segmentos do relato mítico, aqueles que o poeta julga ser o momento em que se concentra o significado de todo o fato. A memória de acontecimentos extraordinários e de grandes empresas transforma-se, então, em memória de fortes emoções, o que condiciona fortemente nossa visão dos mitos gregos.

It is commonly said that spectators of tragedies already knew the myths enacted in them. But what did they really know of these stories? Are the relations between myth and tragedy that linear? The presente article aims precisely at questioning this linearity, by showing the kind of claims, cuts and choices suffered by the mythical material on its way to the scene. Tragedy is restricted to certain segments of the mythical tale, those the poet thinks to be moments in which is concentrated the meaning of the whole fact. The memory of extraordinary events and of great endeavors becomes then the memory of strong emotions, which strongly determines our view of Greeks myths.