Leptospirosis is an important public health problem caused by Leptospira.The objective is to characterize the geographic distribution of pathogenic leptospira serovars in the Americas through a systematic review of the literature between 1930-2017. Searches were conducted in six scientifi c databases (PubMed, Web of Science, Embase, Lilacs, Scopus and Cochrane). We included studies conducted unambiguously in the Americas, that investigated infection of Leptospira in humans and animals in their natural environments with serovar identifi cation. 283 articles were included, of which 69 were studies in humans, 86 in wild animals, and 182 in domestic animals. Most of them conducted in Brazil (104, 36.7%) and in rural environments (158, 55.8%). Bovines, equines and dogs where the most frequently studied domestic species. However, a large diversity including 80 species of wild animals were studied. Icterohaemorrhgiae, Canicola, Pomona and Grippotyphosa were the most common serovars, described in 46 (16.2%), 38 (13.3%), 32 (11.3%) and 26 (9%) of the articles, respectively. The Results i ndicate a large concentration of studies in Latin America, with emphasis on Brazil, in wild mammals and three main domestic animal groups. Our results emphasize the need for studies that delve into the relationships of the epidemiological cycle, environment, and health.

Objective: to evaluate the frequency of painful procedures that premature newborns were submitted to during their stay in a NICU. Method: this is about an analytical and exploratory cross-sectional study. The population was composed of 106 moderately premature newborns, hospitalized during the period from August 3 to August 5 in a private hospital in Salvador (BA), Brazil. The variables were: sex of the newborn, gestational age, hospitalization duration, birth weight and length, Apgar Score in the first and fifth minutes, number of prenatal checkups, and small size for gestational age. The outcome variable was the frequency of painful procedures. The data had been stored e analyzed in Epi Info Windows 3.3.2. The study was approved by the Ethics Committee in Research of Santa Izabel Hospital (FR 83357). Results: demonstrated that the risk for exposition the painful procedures increases when associated: the gestacional age of 31 and 32 weeks, whose relative risk (RR) 1,70 (p=0,01); to the time of superior internment the twenty and seven days in the UTIN, RR 2,05 (p=0,00); to the Bulletin of lesser or equal Apgar the seven, and equal minor the eight in first minute 1,70 (p=0,02) and in the fifth minute, 1,87 ( p=0,03), respectively; to the number of inferior prenatal consultations the six, 1,96 (p=0,00). Conclusion: these data point the necessity for alternatives that minimize the painful procedures that the RNPTM are displayed in the UTIN. Descriptors: pain; premature; nursing care.RESUMOObjetivo: avaliar a frequência de procedimentos dolorosos que os recém-nascidos prematuros moderados (RNPTM) foram submetidos durante a internação em uma UTIN. Método: trata-se de um estudo de coorte retrospectivo analítico e exploratório. A população foi composta por 106 RNPTM, internados no período de agosto de 2003 a agosto de 2005 em um hospital privado de Salvador, Bahia. As variáveis estudadas foram: sexo do recém-nascido, idade gestacional, tempo de internamento, peso ao nascer, Apgar no primeiro e quinto minutos e números de consultas pré-natais. A variável de desfecho foi a frequência de procedimentos dolorosos. Os dados foram armazenados e analisados no Epi Info Windows 3.3.2. O estudo foi aprovado aprovado pelo Comitê de Ética do Hospital Santa Izabel (FR 83357). Resultados: o risco para exposição a procedimentos dolorosos aumenta quando associado: a idade gestacional de 31 e 32 semanas, cujo risco relativo (RR) 1,70 (p=0,01); ao tempo de internamento superior a vinte e sete dias na UTIN, RR 2,05(p=0,00); ao Boletim de Apgar menor ou igual a sete, e menor igual a oito no primeiro minuto 1,70 (p=0,02) e no quinto minuto, 1,87 (p=0,03), respectivamente; ao número de consultas pré-natais inferiores a seis, 1,96 (p=0,00). Conclusão: estes dados apontam a necessidade de alternativas que minimizem os procedimentos dolorosos que os RNPTM são expostos em uma UTIN. Descritores: dor; prematuro; cuidados de enfermagem.RESUMENObjetivo: analizar la frecuencia de procedimientos dolorosos a que los recién nacidos prematuros moderados (RNPTM) fueron sometidos durante el internamiento en una Unidad de Terapia Intensiva Neonatal (UTIN). Método: se trata de un estudio de cohorte retrospectivo analítico y exploratorio. la población fue compuesta por 106 RNPT moderados, internados en el período de agosto 2003 a agosto 2005 en un hospital privado de Salvador, Bahia. Las variables fueron: sexo del RN, edad gestacional, tiempo de internamiento, estatura, peso al nacer, Apgar en el primer y quinto minutos, números de consultas prenatales y pequeño para edad gestacional (PIG). La variable de desfecho fue la frecuencia de procedimientos dolorosos. Los datos fueron almacenada e analizados en el Epi Info Windows 3.3.2. El estúdio fue aprobado  por el Comité de Ética en la Pesquisa del Hospital Santa Izabel (FR 83357). Resultados: el riesgo para exposición a procedimientos dolorosos aumenta cuando asociado: a la edad gestacional de 31 y 32 semanas, RR 1,70 (p=0,01); al tiempo de internamiento superior a veintisiete dias en la UTIN, RR 2,05 (p=0,00); al Boletin de Apgar menor o igual a siete, y menor igual a ocho en el primer minuto RR 1,70 (p=0,02) y en el quinto minuto, RR 1,87 (p=0,03), respectivamente; al número de consultas prenatales inferiores a seis, RR  de 1,96 (p=0,00). Conclusión: estos datos apuntan la necesidad en buscar alternativas que minimizem los procedimientos dolorosos a que los RNPTM son expuestos en las UTIN. Descriptores: dolor; prematuro; atención de enfermería.