Northeastern Region Of Brazil Research Articles

Weathering and mineral alteration of metamorphic rocks and genesis of Planosols along a rainfall gradient in Borborema Province, Northeast Brazil

Soils in Northeast Brazil have a correlation with soils in the Northwest Africa, as Planosols are predominant in these regions. However, the weathering and genesis of these soils are little understood, compromising their use and conservation. The present study aimed to investigate weathering and mineralogical changes as well as genesis of Planosols along a pluviometric gradient, considering their formation from gneiss rocks, and analyze climate influence on soil formation. We collected three profiles in different climatic regions of the Brazilian northeastern region and described and classified the samples morphologically. We also performed the physical, chemical, mineralogical, and micromorphological analyses. The results indicated that external material added to soil surface contributed to the formation of surface horizons rich in coarser fractions. Subsurface horizons however were rich in clay (e.g.: P1–2Bn: 433 g kg−1; P2-2B: 427 g kg−1; P3-2Bn1: 429 g kg−1) and were formed from changes of the parent material and the clay formation in situ. Biotite, plagioclases, K-feldspars, and hornblende are the main primary minerals sources for the formation of clay minerals (mainly smectite and kaolinite) from transformation processes and neoformation. Pedoplasmation, monosiallitization, bisiallitization, redoximorphism, and alkalization contributed to the formation of the Planosols studied. Despite incipient soil evolution, the Planosols displayed variation according to the climatic condition. Nevertheless, the incipient mineral alteration favored important soil attributes that could influence agricultural productivity, even in the region with higher precipitation rates.

Flesh Flies (Diptera: Sarcophagidae) of Forensic Importance Collected From Pig Carcasses in the Cerrado of Northeastern Brazil.

Sarcophagidae is a family of true flies frequently found colonizing carcasses and corpses as adults and/or larvae, therefore, they are of great forensic value in the medico-legal field. Thus, this study aims to inventory the sarcophagids species and describe their succession process in the decomposition of swine carcasses in the Cerrado (savanna-like vegetation), Brazilian Northeastern region. A total of 10,819 specimens were collected, belonging to 45 sarcophagid species. Of this total, one species was recently described (Helicobia neuzalmeidae Silva, Brasil, De-Souza & Carvalho-Filho), two [Blaesoxipha (Acanthodotheca) denieri (Blanchard) and Dexosarcophaga pusilla Lopes] are new records for the Cerrado biome, five [Argoravinia (Argoravinia) catiae Carvalho Filho & Esposito, B. (A.) denieri, Nephochaetopteryx orbitalis (Curran & Walley), Peckia (Sarcodexia) tridentata (Hall) and Tricharaea (Sarcophagula) ramirezi (Lopes)] are new records for the Northeast region and eight are new records for the state of Maranhão. The species A. (A.) catiae, Blaesoxipha (Gigantotheca) stallengi (Lahille), D. pusilla, H. neuzalmeidae, Lipoptilocnema misella Lopes, Oxysarcodexia bakeri (Aldrich) and Retrocitomyia retrocita (Hall) were collected for the first time in pig carcasses. Peckia (Sarcodexia) lambens (Wiedemann) and Oxysarcodexia thornax (Walker) were the most abundant species. In both collection seasons, five species were carcasses pioneers at an early stage. The majority of species (42 spp.) were collected during the dry season, primarily during the black putrefaction (39 spp.) and butyric fermentation (30 spp.) stages. The greatest number specimens (n = 6,484) were recorded during the rainy season, at the butyric fermentation (n = 2,517) and black putrefaction (n = 2,080).

Typifications and three new synonymies in Evolvulus L. (Convolvulaceae-Cressae)

Evolvulus comprises approximately 100 American species and is one of the largest genera in Convolvulaceae; it includes taxa that are sometimes difficult to identify; some of them have typification and taxonomic problems. Both nomenclatural and taxonomic issues were detected during the ongoing taxonomic treatment of the Evolvulus species from the northeastern region of Brazil. This study was conducted with a comprehensive protologue analysis, study of herborized specimens, including types, observation of populations in the field, and morphological analysis. From our conclusions, five lectotypifications, one second-step lectotypification, one neotypification for E. luetzelburgii and three new synonyms are proposed herein.

Spatiotemporal Kriging for Days without Rainfall in a Region of Northeastern Brazil

Climate change has had several negative effects, including more severe storms, warmer oceans, high temperatures and, in particular, increased drought, directly affecting the water availability in a region. The Northeast Region of Brazil (NEB) is known to have scarce rainfall, especially in the northeastern semiarid region. Droughts and high temperatures in the NEB negatively affect water resources in the region, resulting in a gradual decrease in the storage volume in the reservoirs and contributing to unprecedented water scarcity. The objective of this research was to investigate the spatiotemporal behavior of the number of days without rain (DWR) in a region of northeastern Brazil, making use of the spatiotemporal geostatistical methodology. Cross-validation resulted in an R2 of 71%, indicating a good performance of spatiotemporal kriging for predicting DWRs. The results indicate a spatial dependence for a radius of up to 39 km and that the DWR observations in a certain location influence its estimates in the next 2.8 years. The projection maps from 2021 to 2030 identified a growing trend in the DWRs. With the results presented in our study, it is expected that they can be used by government agencies for the adoption of public policies aiming to minimize the possible damage caused by long periods of drought.

GEOTHERMAL ENERGY: AN ALTERNATIVE TO THE WATER–ENERGY DILEMMA IN NORTHEASTERN BRAZIL

This paper proposes geothermal energy as an alternative solution to the water–energy dilemma in the northeastern region of Brazil (NEB). The main application of this study was to provide a theoretical basis to support a different approach to policies minimizing water scarcity and ensuring sustainability. The analysis developed in this study compares the levelized cost of electricity (LCOE) for many different energy sources. The novelty of this study is the use of geothermal energy in the context of the Brazilian Northeast, focusing on water desalination processes, which are expensive in terms of energy. Therefore, this study is highly important because it offers the potential of addressing the energy/economic barrier related to water desalination in environments with economically viable geothermal energy. This is the case in Northeast Brazil with potential for reuse of abandoned oil wells. In the form of enhanced geothermal systems (EGS), geothermal energy is a competitive energy source compared to other sources in the Brazilian Energy Matrix, especially when considering factors in addition to the economic benefits. In the form of EGS, geothermal energy is a suitable option for addressing water scarcity in the northeast region in a sustainable and low-emission manner. This is a strategic opportunity for NEB in the context of energy production and freshwater production through desalination.

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast.

This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

Demands and use of health services among immigrants from a metropolitan region in northeastern Brazil

Resumo Objetivo analisar as demandas e a utilização dos serviços de saúde por imigrantes na Região Metropolitana de Aracaju, Sergipe. Método recrutaram-se, pelo método bola de neve, 186 imigrantes, alocados em clusters relacionados à renda per capita do país de origem e países da América Latina ou não. Utilizou-se questionário auto aplicado sobre as condições e práticas de saúde. Resultados imigrantes de países com renda baixa e média baixa (IMB) são mais jovens, com menor tempo de permanência no Brasil, possuem ensino fundamental/médio, exercem atividade laboral sem carteira de trabalho assinada e renda de até um salário mínimo (p<0,05). Imigrantes da América Latina (IAL) possuem aproximadamente duas vezes mais chances de ter alguma doença crônica não transmissível (DCNT), comparados aos imigrantes de outros países (IOP). A idade e o tempo de permanência no Brasil influenciam na autoavaliação da saúde, na busca por serviços de saúde e ter alguma DCNT (p<0,05). O Sistema Único de Saúde foi o mais buscado tanto na chegada ao Brasil quanto nos últimos 12 meses, principalmente pelos IMB e IAL (p<0,05). Conclusão e implicações para a prática observaram-se diferenças dentro dos subgrupos de imigrantes, principalmente em termos de padrões de utilização, ressaltando a importância da competência transcultural na assistência.

Destaques históricos do mormo, de 2007 a 2017, no Estado do Maranhão, Brasil

ABSTRACT: Glanders is an infectious disease of equids caused by Burkholderia mallei, a facultative intracellular non-mobile Gram-negative bacterium that can be transmitted to other animals and humans. This study described glanders cases reported in the state of Maranhão, located within an Amazon-Cerrado transition region in northeastern Brazil, from 2007 to 2017. A database in an electronic spreadsheet (Microsoft Excel 2010) was developed containing information on the number of positive animals according to age, sex, purpose, year and month, municipality and mesoregion of origin of the animal. The descriptive analyzis was performed on data provided by the State Agency for Agricultural and Livestock Protection of the state of Maranhão (AGED), and by the official private laboratory. As the database did not have information data about negative animals, possible risk factors could not be evaluated. Among the total of 62,555 equids were evaluated by means of the complement fixation test (CFT), 59,036 were horses, 2,981 mules and 538 donkeys. Thirty-five samples (0.06%) reacted in the CFT. Five additional samples were by the western blot technique and three of them were positive. All the reactive horses (Equuscaballus) were from rural areas. Results presented here indicate that glanders may be endemic in the state of Maranhão and is a public health concern.

REPRESENTAÇÕES SOCIAIS ELABORADAS POR DISCENTES DE ENFERMAGEM SOBRE A PREVENÇÃO DA COVID-19

ABSTRACT Objective: to understand the social representations elaborated by nursing students about the prevention of COVID-19. Method: exploratory-descriptive and qualitative research. Data were produced through interviews with 32 participants, conducted in the period from September 2021 to July 2022. The Study Setting was a public higher education institution, located in the northeastern region of Brazil. Data were processed using IRaMuTeQ software. Results: the genesis of the social representations of COVID-19 prevention pointed to two axes: Organization of ideas about COVID-19 prevention measures, and Efficiency, reliability and source of the information obtained. Final Considerations: the social representations showed the knowledge about the prevention measures of COVID-19, provided an opportunity to clarify the origin of the students’ knowledge and the specificities they consider important. It is hoped that this study can serve as a foundation for further research and/or interventions with nursing students.

Comparative study of the physiological and health quality of traditional and biofortified cowpea seeds.

Cowpea is one of the main crops in family agriculture, especially in the Northeastern region of Brazil, and it is expanding to other regions in Brazil. The use of seeds with low physiological and health quality is reflected in the plant development and consequently yield, making it important to study the seed physiological and health quality. The objective of the present study was to assess the physiology and health of traditional and biofortified cowpea seeds. The traditional cowpea varieties (Angelim, Mercado and Manteguinha) and the biofortified cowpea cultivars (BRS Aracê, BRS Xique-Xique and BRS Tumucumaque) were assessed for the following physiological parameters: water content (WC), first count (FC), germination test (G), germination speed index (GSI), seedling emergence in the greenhouse (E), emergence speed index (ESI), seedling aerial part and root length (APL and RL) and electric conductivity test (EC). The seed health quality was assessed by the Blotter Test. The water content present in the seeds of the traditional and biofortified varieties ranged from 10% to 14%. All the traditional and biofortified varieties showed high germination and emergence value in the greenhouse. The germination and emergence speed indexes indicated the BRS Aracê and BRS Xique-Xique cultivars as the most vigorous. In the health tests the highest indexes were the storage fungi Aspergillus sp., Cladosporium sp. and Penicillium sp., with the highest prevalence in the BRS Tumucumaque variety, which was probably related to the higher water content present in this variety.

Performance of ‘BRS Magna’ vines grown under different training systems, rootstocks and production cycles

Over the past decade, the business of producing juice from grapes (Vitis labrusca L. and hybrids) has been expanding in response to increasing consumption encouraged by campaigns promoting the benefits grape juice can have on health. This study aimed to determine the effect of the production cycle, vine training system, and rootstock on the yield and physical and physical-chemical characteristics of ‘BRS Magna’ grapes grown in the Vale do Submédio São Francisco in the northeastern region of Brazil. The study was conducted in Petrolina, Pernambuco, over eight production cycles (2017 to 2020). The grapevines were trained in three vine training trellis systems: espalier, lyre, and pergola; and grafted onto two rootstocks: IAC 572 and IAC 766. The production cycle, training system, and rootstocks affected the yield components, vigor, and physical characteristics of the BRS Magna grapes. The combination of the pergola training system and rootstock IAC 766 stood out from the others, providing mean yields estimated at 26 t ha –1 per production cycle. The soluble solids content (SS), titratable acidity (TA), and SS TA –1 ratio were affected neither by the training system nor the rootstock, and higher values for SS and lower values for TA were obtained in the first, second, fourth and eighth production cycles. Thus, the pergola training system and rootstock IAC 766 are recommended for promoting yield gains in the ‘BRS Magna’ grape in the Vale do Submédio São Francisco.

Estratégias de seleção de linhagens de feijão-comum quanto à produtividade e à qualidade comercial de grãos

Abstract The objective of this work was to evaluate common bean lines for yield and commercial grain quality in multi-environments, and to maximize the efficiency of selection using complementary methods. Over three crop years, 79 trials using carioca common bean lines were carried out in the dry, winter, and rainy crop seasons, in the Southern, Southeastern, Midwestern, and Northeastern regions of Brazil. The experimental design was a randomized complete block with three replicates and 17 genotypes. The evaluated traits were: grain yield (GY), grain appearance (GA), sieve yield (SY), and 100-seed weight (100SW). Adaptability and stability analyses were carried out using models that consider the genotype effect as fixed or as random, in a mixed-model perspective. A significant interaction between genotypes and environments was observed for all traits evaluated. The CNFC 15086 line presented the highest GY and 100SW, besides a high adaptability and stability. The most prominent line for GA was CNFC 15038. The CNFC 15097 line is recommended as a cultivar (BRS FC406) because it shows, simultaneously, favorable performances for GY, GA, SY, and 100SW, as well as for adaptability and stability.

Parasitological, epidemiological, and hematological findings in Spix's yellow-toothed cavy (Galea spixii Wangler, 1831) in the State of Paraiba, northeastern Brazil

Brazil is composed of large ecosystems with vast biodiversity in fauna and flora. Agriculture and livestock farming provides an interaction between humans and domestic and wild animals, which favors the dissemination of infectious and parasitic agents. Wild rodents present a wide ecological diversity; therefore, it is necessary to know which species may be carriers of pathogens. This study aims to identify endo and ectoparasites, and hemoparasites in Spix's yellow-toothed cavy (Galea spixii Wangler, 1831), and determine the hematological parameters of this species. The study was carried out with 16 adult specimens from both sexes, captured in the rural areas of Remigio and Areia, Paraiba State, northeastern Brazil. All Spix's yellow-toothed cavies presented ectoparasites, Gliricola quadrisetosa, Gyropus ovalis, Laelaps sp. and Chirodiscoides caviae, and endoparasites identified by the presence of Nematode eggs, Cestode eggs, and coccidian oocysts in the stool samples. To the best of our knowledge, this is the first report of parasitism by Gyropus ovalis, Laelaps sp. and Chirodiscoides cavia in Spix's yellow-toothed cavy. Animals tested negative by PCR for hemotropic Mycoplasma sp., Babesia sp., Ehrlichia sp., and Bartonella sp. For the first time, the hematological profile of these animals was determined. These results can be the basis for future research with the species, which can be used as a sample animal in experiments in clinical settings as an epidemiological guide since this species is routinely used by impoverished populations in the Northeastern region of Brazil as pets, as well as a source of protein.

Magnetic modelling and physical properties of magnesite deposits and regional sequences of Serra das Éguas, Brumado, Brazil

AbstractThe Serra das Éguas Complex, in Brumado, state of Bahia, located in the northeastern region of Brazil, is a geological structure comprising volcanochemical, siliciclastic and carbonate units that contain layers and lenses of magnesite, important as a refractory in steel, cement, glass and copper and other applications. Considering the importance of such sort of deposit, this work aims to (i) study the physical properties of magnesite deposits via direct measurements of radiometric spectrometry and magnetic susceptibility associated with chemical analysis of the available borehole core samples; (ii) analyse the magnetic and radiometric data acquired by the combined airborne survey over the area with known magnesite deposits; (iii) estimate the magnetic response of the magnesite deposits and surrounding rock formations via 2D forward and 3D inverse magnetic modelling; (iv) evaluate and, if necessary, reconsider the stratigraphic sequences of the identified geological units of the Complex using the results of the 2D and 3D magnetic modelling. Through forward/inverse models, we noted an expressive magnetic signature likely related to the iron formations and metamafic and meta‐ultramafic rocks. The radiometric data analysis on the drill cores showed that the reddish magnesite has a well‐defined U/Th signature. Furthermore, the results show that the carbonate unit, which contains the magnesite deposits, has the lowest amplitude of magnetization values, and both signatures might be helpful for their identification. Additionally, the magnetic models show that the carbonate unit lies in the upper part of the stratigraphic sequence of the Serra das Éguas Complex. This conclusion drives us to propose a new stratigraphy sequence, where the volcanochemical unit that includes the iron formations lies at the bottom of this stratigraphic sequence.

Temperatures and substrates on the germination and vigor of seeds of Pilosocereus catingicola subsp. salvadorensis in the Caatinga biome of Paraíba

The Caatinga biome is presented in the vegetation where the Brazilian semiarid region predominates, with a great variety of native species, and facheiro is one of the most important species because of its wide range in the semiarid region in northeastern Brazil. Therefore, the knowledge of the germinative behavior of the Caatinga species is essential to subsidize conservationist actions in this ecosystem. This study aimed to determine the effect of temperature and substrate on the germination and vigor of facheiro’s seeds. These seeds were obtained from ripe fruits collected in three localities of the Agreste of Paraíba: Arara, Bananeiras, and Boa Vista. After extraction, the seeds were placed to dry on paper for one week in a laboratory environment. Subsequently, the experiment was started by testing four temperatures: 20, 25, 30, and 20-30 °C. The germination test was conducted with four replications of 50 seeds distributed in “gerbox” boxes and placed in bio-oxygen demand (BOD) chambers using as a substrate the germitest paper, with a photoperiod of 12 hours. The statistical design was randomized in a 3 × 4 factorial arrangement (3 localities and 4 temperatures). A significant effect was observed for populations and substrates. The best substrate for germination was the germitest, while the substrate vermiculite presented a good performance, and the substrate soil presented low germination. Therefore, seeds presented the best vigor in the germitest paper, mainly with a temperature of 25 °C where the best performance for all localities was found. The vigor of seeds in the localities of Bananeiras and Boa Vista, temperatures of 25, 30, and 20-30 °C, and substrate germitest paper provided the highest vigor. The germitest substrate is the recommended substrate for the germination of the species, maximizing its physiological potential and being able to accelerate conservation projects for the species.

A Comparative Analysis of the Socio-Demographic Development of the Cities in Siberia and Amazonia in the second half of the 20th century

The article examines the prospects of using a comparative analysis in the study of the socio-demographic processes in the Northeastern regions of Brazil (Amazonia) and Siberia. The authors hypothesize that one of the optimal cases for comparison with Siberia is Amazonia. A comparative analysis suggests that the compared cases (a set of objects, phenomena and processes) should have a number of similar and distinctive features, while at the same time having tangible differences. Despite the seeming heterogeneity, Amazonia and Siberia have many similarities. Among the elements of similarity, the frontier position stands out in the first place. Both Siberia and Amazonia were the regions of European colonization. Throughout the 20th century, Siberia continued to be a relatively undeveloped territory, in fact, still being a frontier. Brazil's Amazon plays a similar role. Both regions have a similar economic profile and act as resource regions that are rich in timber, metals and other minerals as well as having similar energy profiles. The article highlights that the development in both regions peaked in the second half of the 20th century, and also discusses similar phenomena in the demographic processes in these regions. The findings have allowed the authors to formulate the main directions for further comparative analysis of the socio-demographic development of the large urban centers in Siberia and Amazonia.

Ethnobotanical knowledge of herbalists about medicinal plants from the semiarid region in northeastern Brazil

Medicinal plants have been used since ancient times to treat illnesses. This study aimed to identify through questionnaire the medicinal plants most frequently sold on public and street markets in some municipalities of Paraíba state, northeastern Brazil, and the knowledge of herbalists about their therapeutic indications and forms of use. The sample consisted of 28 herbalists. Fifteen plants with a dental indication were identified, including barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), gengibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) andquixaba (Sideroxylon obtusfolium), as well as 21 plants used for the treatment of general diseases, including barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) and erva doce (Pimpinella anisum). Bottled preparations ("garrafadas")and teas were the most frequently indicated forms of use. The results suggest that herbalists have a vast traditional knowledge of the therapeutic potential of commercialized plants.

Lower Permian aeolian dunes surrounding lakes in Gondwana: Insights on depositional dynamics, cyclicity pattern and climatic control from the Parnaiba basin (Brazil)

The Permian Pedra de Fogo Formation is located in the Parnaíba Basin, northeastern region of Brazil, and high-resolution description of composite sedimentary logs with a total of 66 m led to the recognition of five different facies associations, and exhibits a sediment accumulation of: (1) playa lake; (2) offshore transition; (3) shoreface; (4) aeolian sand sheet; and (5) aeolian dune and interdune. The stratigraphic succession can be separated into three stratigraphic intervals characterized by different facies associations, termed: lower, middle and upper interval. The lower interval is composed by playa lake facies association and lacks aeolian deposits indicating that the water table or its capillary fringe reached the depositional surface, causing a reduction in the availability of dry sand, preventing the development of dunes and aeolian sand sheets. The middle interval consists of offshore transition, shoreface, aeolian sand sheet and aeolian dunes facies associations, indicating wide lake environments with a coastal aeolian system. This interval has a general progradational trend characterized by an increase in the proportion of aeolian deposits to the top. This general progradational stacking pattern is composed of nested shallowing upward high frequency cycles, suggesting that the regressive trend was not linear, being marked by numerous transgressions and regressions of the lacustrine coastline. The upper interval represents the return of the playa lake with tree-ferns stems and leaves at the top, suggesting ephemeral lake system. The depositional context indicates that the mid-palaeolatitudes of Gondwana were not permanently arid or semi-arid during the Cisuralian, since several wetter climate periods also occurred, allowing the development of wide and perennial lake bodies that permitted the maintenance of a rich palaeofauna and palaeoflora. Analysis of aeolian dune foresets dip direction and subsequent correction of the rotation of the South American plate considering the paleogeographic position of the basin during the deposition period, show good compatibility with atmospheric circulation model proposed to Early Permian that indicates winds blowing to N in the Parnaíba Basin.

Dos versos aos palcos e dos palcos às telas: O processo intertextual do filme “O Auto da Compadecida” (2000)

The film Auto da Compadecida (2000), by Guel Arraes, is an adaptation of the play, which has the same name, written by Ariano Suassuna in 1955. Before reaching the screens of the movie theaters “O Auto da Compadecida” had already been converted to other compositions, as in films and tv shows. Therefore, far beyond being an adaptation based in a single hypotext, the movie end up incorporating characteristics of differents semiotics systems, recovering, specially, the traces of popular northeastern culture, particularly the cordel’s literature - a typical popular literature from the brazilian northeastern region, illustrated by xylography and written in verses. The script by Guel, in collaboration with Adriana e João Falcão, derives from this succession of textual transformations in this trajectory by different semiotics systems, demonstrated in verses, stages and screens. This article aims to analyze the movie script in transtextual perspective according to the theories of languages presented in the book Palimpsests by Gérard Genette. For this purpose, we describe the distinct narrative options that composed the script, in order to approach the adaptive process of the movie based on the classification presented by Genette. Our objective is to analyze the elements that construct the transmutation of the narrative structure of cordel and theatrical narrative in the screenplay of the film, the stylistic transformations and the way that the transtextual relationship of the hypertext under analysis occurs.

Severe Visceral Leishmaniasis Associated With COVID-19 and Complicated by Hemophagocytic Syndrome.

To the Editors: Visceral leishmaniasis (VL) is a parasitic infectious disease that mainly affects children. if neglected the disease could become systemic.1 Coronavirus disease 2019 (COVID-19) is a viral disease that could complicate the management of several infectious diseases in different regions worldwide.2 Managing severe pediatric VL associated with COVID-19 and complicated by hemophagocytic syndrome (HPS) as well as finding an efficient therapeutic protocol to reduce mortality is a challenge. VL associated with HPS and COVID-19 have not been reported previously; therefore, a report of a case with a favorable outcome is extremely important. We present the case of a pediatric patient with VL complicated with HPS and associated with COVID-19. A 9-month-old infant, female, living in the northeastern region of Brazil was admitted caused by intermittent fever, vomiting after feedings, weight loss, and abdominal distention. Further investigations revealed pancytopenia with severe neutropenia and anemia, hypoalbuminemia, hepatosplenomegaly, hypertriglyceridemia, hypofibrinogenemia, high ferritin level, and urosepsis. Chest radiography showed diffuse perihilar infiltrates. A myelogram revealed numerous isolated forms of Leishmania sp. and hemophagocytosis figures. After severity score testing, the patient was diagnosed with severe VL complicated by HPS, and was treated with liposomal amphotericin B, corticoid, and human immunoglobulin. The patient developed acute respiratory failure, and reverse-transcriptase polymerase chain reaction (RT-PCR) for COVID-19 tested positive. The patient subsequently developed a renal injury, septic shock and coagulopathy, and required pediatric intensive care with invasive ventilation, peritoneal dialysis, vasoactive drugs and blood products. After 13 days of intensive care, clinical improvement was observed and the patient was transferred to the ward. The patient’s general clinical status improved; hence, the patient was discharged and followed up as an outpatient with favorable outcomes (Figure 1).FIGURE 1.: Diagram showing how the combination of Leishmania and SARS-CoV-2 led to HPS. HPS indicates hemophagocytic syndrome.HPS associated with VL is well known.1 The uniqueness of this case report is the pulmonary involvement of COVID-19, which increased its severity. Further, liposomal amphotericin B treatment was extended to 14 doses because of persistent clinical and laboratory signs of VL and symptoms of COVID-19; however, the Brazilian protocol prescribes 7 doses. VL is an immune-mediated disease that mainly affects children caused by their immature cell-mediated immunity. The amastigotes of the parasite multiply inside macrophages and subsequently spread through the blood to the lymph nodes, liver, spleen and bone marrow. This leads to uncontrolled activation of T lymphocytes, natural killer cells and macrophages, and could increase the levels of proinflammatory cytokines and lead to HPS.3 Generally, the clinical features of VL overlap with those of HPS. Regarding the COVID-19/HPS association, the immune syndrome induced by COVID-19 is not yet fully understood; however, the presence of an inflammatory response is certain.4 Another condition that is associated with COVID-19 is pediatric multisystemic inflammatory syndrome, which presents with inflammatory response with clinical and laboratory changes that can mimic HPS.5 Delayed diagnosis of HPS associated with VL, probably because of clinical similarities, may result in severe complications and death in up to 90% of untreated cases.6 The association of VL, HPS and COVID-19 have not been described in the literature; therefore, dissemination of this case report is fundamental, as it highlights the importance of therapeutic, clinical and epidemiological management.