Sudden Cardiac Death in Brazil: Study Based on Physicians' Perceptions of the Public Health Care System

Background: There are no available statistical data about sudden cardiac death in Brazil. Therefore, this study has been conducted to evaluate the incidence of sudden cardiac death in our population and its implications. Methods: The research methodology was based on Thurstone's Law of Comparative Judgment, whose premise is that the more an A stimulus differs from a B stimulus, the greater will be the number of people who will perceive this difference. This technique allows an estimation of actual occurrences from subjective perceptions, when compared to official statistics. Data were collected through telephone interviews conducted with Primary and Secondary Care physicians of the Public Health Service in the Metropolitan Area of Sao Paulo (MASP). Results: In the period from October 19, 2009, to October 28, 2009, 196 interviews were conducted. The incidence of 21,270 cases of sudden cardiac death per year was estimated by linear regression analysis of the physicians responses and data from the Mortality Information System of the Brazilian Ministry of Health, with the following correlation and determination coefficients: r = 0.98 and r2= 0.95 (95% confidence interval 0.81.0, P < 0.05). The lack of waiting list for specialized care and socioadministrative problems were considered the main barriers to tertiary care access. Conclusions: The incidence of sudden cardiac death in the MASP is high, and it was estimated as being higher than all other causes of deaths; the extrapolation technique based on the physicians perceptions was validated; and the most important bureaucratic barriers to patient referral to tertiary care have been identified. (PACE 2012; 35:13261331)

Fishes of Paranagua Estuarine Complex, South West Atlantic

The objective of this work was to present an updated checklist of the currently known fishes in the Paranagua Estuarine Complex (PEC) and provides comments on conservation status for the treated species. We used a large dataset derived from a pool of studies which have been conducted within there along the last 30 years. Each study was based on monthly samplings and conducted in several estuarine habitat; thus, the pool covers practically all estuarine habitats and takes into account the seasonal cycle in the system. The PEC ichthyofauna represents a mixture between that fauna typical from the tropical Brazilian coast and that with affinities of temperate Argentinean and Uruguayan zones. The PEC harbors a rich fish fauna of 213 species, inserted in the families that are common along the Brazilian coast. Only a minor part (8%) of the PEC fish fauna was evaluated as regards the conservation status, mostly because of the lack of basic biological and ecological information for most species. Despite part of the among-estuaries differences are due to different and incomplete sampling efforts, the richness in the PEC is surprisingly higher than other systems in Brazil and around world, which emphasize the importance of the region for global biodiversity conservation.

Fishes of Paranaguá Estuarine Complex, South West Atlantic

The objective of this work was to present an updated checklist of the currently known fishes in the Paranaguá Estuarine Complex (PEC) and provides comments on conservation status for the treated species. We used a large dataset derived from a pool of studies which have been conducted within there along the last 30 years. Each study was based on monthly samplings and conducted in several estuarine habitat; thus, the pool covers practically all estuarine habitats and takes into account the seasonal cycle in the system. The PEC ichthyofauna represents a mixture between that fauna typical from the tropical Brazilian coast and that with affinities of temperate Argentinean and Uruguayan zones. The PEC harbors a rich fish fauna of 213 species, inserted in the families that are common along the Brazilian coast. Only a minor part (8%) of the PEC fish fauna was evaluated as regards the conservation status, mostly because of the lack of basic biological and ecological information for most species. Despite part of the among-estuaries differences are due to different and incomplete sampling efforts, the richness in the PEC is surprisingly higher than other systems in Brazil and around world, which emphasize the importance of the region for global biodiversity conservation.