Trends in systemic lupus erythematosus mortality rates in the state of Sao Paulo, Brazil from 1985 to 2004

Objectives To estimate mortality rates and mortality trends from SLE in the state of Sao Paulo, Brazil. Material and methods The official data bank was used to study all deaths occurred from 1985 to 2004 in which SLE was mentioned as the underlying cause of death. Besides the overall mortality rate, the annual gender- and age-specific mortality rates were estimated for each calendar year by age bracket (0-19 years, 20-39 years, 40-59 years and over 60 years) and for the sub-periods 1985-1995 (first) and 1996-2004 (second), by decades. Chi-square test was used to compare the mortality rates between the two periods, as well the mortality rates according to educational level considering years of study. Pearson correlation coefficient test was used to analyse mortality trends. The crude rates were adjusted for age by the direct method, using the standard Brazilian population in 2000. Results A total of 2,601 deaths (90% female) attributed to SLE were analysed. The mean age at death was significantly higher in the second than in the first sub-period (36.6 +/- 15.6 years vs. 33.9 +/- 14.0 years; p<0.001). The overall adjusted mortality rate was 3.8 deaths/million habitants/year for the entire period and 3.4 deaths/million inhabitants/year for the first and 4.0 deaths/million inhabitants/year for the second sub-period (p<0.001). In each calendar year, the mortality rate was significantly lower for the better educated group. Throughout the period, there was a significant increase in mortality rates only among women over 40. Conclusion SLE patients living in the state of Silo Paulo still die at younger ages than those living in developed countries. Our data do not support the theory that there was an improvement in the SLE mortality rate in the last 20 years in the state of Sao Paulo. Socio-economic factors, such as the difficulty to get medical care and adequate treatment, may be the main factors to explain the worst prognosis for our patients.

Chagas disease-related mortality trends, state of Sao Paulo, Brazil, 1985 to 2006: a study using multiple causes of death

Objectives. To study mortality trends related to Chagas disease taking into account all mentions of this cause listed on any line or part of the death certificate. Methods. Mortality data for 1985-2006 were obtained from the multiple cause-of-death database maintained by the Sao Paulo State Data Analysis System (SEADE). Chagas disease was classified as the underlying cause-of-death or as an associated cause-of-death (non-underlying). The total number of times Chagas disease was mentioned on the death certificates was also considered. Results. During this 22-year period, there were 40 002 deaths related to Chagas disease: 34 917 (87.29%) classified as the underlying cause-of-death and 5 085 (12.71%) as an associated cause-of-death. The results show a 56.07% decline in the death rate due to Chagas disease as the underlying cause and a stabilized rate as associated cause. The number of deaths was 44.5% higher among men. The fact that 83.5% of the deaths occurred after 45 years of age reflects a cohort effect. The main causes associated with Chagas disease as the underlying cause-of-death were direct complications due to cardiac involvement, such as conduction disorders, arrhythmias and heart failure. Ischemic heart disease, cerebrovascular disorders and neoplasms were the main underlying causes when Chagas was an associated cause-of-death. Conclusions. For the total mentions to Chagas disease, a 51.34% decline in the death rate was observed, whereas the decline in the number of deaths was only 5.91%, being lower among women and showing a shift of deaths to older age brackets. Using the multiple cause-of-death method contributed to the understanding of the natural history of Chagas disease.

A new genus of Ectinosomatidae (Copepoda, Harpacticoida) from sublittoral sediments in Ubatuba, Sao Paulo State (Brazil), an updated key to genera and notes on Noodtiella Wells, 1965

Both sexes of a new genus and species of Ectinosomatidae (Copepoda, Harpacticoida) from sublittoral sediments collected on the inner continental shelf in Ubatuba, Sao Paulo State (Brazil) are described in detail. Chaulionyx gen. n. (type species: C. paivacarvalhoi sp. n.) differs from all known genera in the presence of a conspicuous bifid spine on the prehensile P1 endopod. It can be differentiated from other genera with a prehensile endopod (Halophytophilus Brian, 1919; Bradyellopsis Brian, 1925; Klieosoma Hicks & Schriever, 1985) by the presence of distinctive subrectangular middorsal pores on the urosomites and the unarmed male sixth legs. The genus Lineosoma Wells, 1965 is recognized as a paraphyletic taxon and relegated to a junior subjective synonym of Noodtiella Wells, 1965. Arenosetella pectinata Chappuis, 1954a is removed from its floating position in Ectinosomoides Nicholls, 1945, transferred to the genus Noodtiella as N. pectinata comb. n. and considered the senior subjective synonym of N. toukae Mitwally & Montagna, 2001. Dichotomous keys are provided for the identification of the 18 valid species of Noodtiella and the 21 valid genera of the family Ectinosomatidae. Halophytophilus aberrans Wells & Rao, 1987 is placed species incertae sedis in the family.

Rediscovery and redescription of the type of Philodryas laticeps Werner, 1900 and the taxonomic status of P. oligolepis Gomes, 1921 (Serpentes, Colubridae)

Philodryas laticeps Werner, 1900 was previously known only from the holotype, which was believed to be lost during the World Wars. We found the holotype to be housed in the Museum fur Naturkunde, Berlin and here redescribe it and report on three additional specimens from the collections of the Instituto Butantan, Sao Paulo and Museum fur Naturkunde, Berlin. We conclude that Philodryas oligolepis Gomes, 1921 and P. affinis Muller, 1928 are junior synonyms of Philodryas laticeps Werner, 1900. All specimens share the presence of a black mucosa surrounding the larynx and trachea in the floor of the mouth and distal rows of middle sized spines disposed in a typical ""V-shaped"" configuration on the asulcate surface of the hemipenial body, two uniquely derived features absent in all other species of the genus Philodryas. Intraspecific variation of external morphology, hemipenes, and coloration are documented.

Contributions to the taxonomy of the Normanellidae (Copepoda, Harpacticoida): description of a new genus from the Brazilian continental shelf and re-assignment of Pseudocletodes vararensis Scott & Scott, 1893 (ex Nannopodidae)

A new genus and species of Normanellidae (Copepoda, Harpacticoida), Paranaiara inajae gen. et sp. nov., is described from the continental shelf off the northern coast of Sao Paulo State, Brazil. The new genus differs from the type genus Normanella Brady, 1880 and Sagamiella Lee & Huys, 1999 in its presence of lamelliform caudal rami, a maxillulary endopod represented by 2 setae, an unarmed maxillipedal syncoxa, and reduced setation on P2 enp-2 (without outer spine) and P3 enp-2 (with only 2 inner setae). All these apomorphic character states are shared with the genus Pseudocletodes Scott & Scott, 1893, formerly placed in the family Nannopodidae (ex Huntemanniidae) and here assigned to the Normanellidae. Pseudocletodes can be differentiated from Paranaiara by the loss of the P1 endopod and of the inner seta on P2-P4 enp-1, the presence of only 2 inner setae on P2 enp-2 (instead of 3) and only 1 inner seta on P4 exp-3 (instead of 2), the presence of a second inner seta on P4 enp-2 (instead of 1), the morphology of the fifth pair of legs which are not medially fused and have only 3 endopodal elements (instead of 4) in the male, and the well developed caudal ramus seta V (instead of rudimentary). It is postulated that prehensility of the P1 endopod was secondarily lost in the common ancestor of Paranaiara and Pseudocletodes. An updated family diagnosis of the Normanellidae and a dichotomous identification key to the 22 currently valid species are presented.