Historical analysis of the records of sylvan yellow fever in the State of Amazonas, Brazil, from 1996 to 2009

IntroductionYellow fever is a non-contagious infectious disease, highly lethal, transmitted by the Aedes, Haemagogus and Sabethes.MethodsDescriptive retrospective study of the yellow fever cases in Amazonas, between 1996 and 2009.ResultsForty two cases of yellow fever were confirmed, with 30 deaths, 10% of which were foreigners.ConclusionsThe presence of Aedes aegypti and Aedes albopictus in both rural Amazonas and its capital demonstrates the dispersion of these vectors and underscores the need for better and continuous epidemiological and entomological control.

Escavações arqueológicas no Mosteiro de S. Martinho de Tibães: campanha de 1996: claustro do refeitório e Jardim de São Bento: relatório científico

Dando sequência ao projeto de estudo histórico-arqueológico implementado em 1992 (ver relatórios e memorandos anteriores), realizou-se em 1996 mais uma campanha de escavações arqueológicas. Integralmente financiados pelo Instituto Português do Património Arquitetónico e Arqueológico (IPPAR) e executados pela Unidade de Arqueologia da Universidade do Minho, os trabalhos arqueológicos foram realizados pela seguinte equipa: Luis F. de Oliveira Fontes, arqueólogo; Eurico Nuno Malheiro Machado, téc. Aux.; Arlindo da Rocha Pinheiro, Arnaldo Gomes, José da Costa Pinheiro, Francisco Alves Gomes, José Carlos Dias, José Emílio Correia Coelho, Maria Manuela Gonçalves Ferreira e Miguel Fernando Dias Veiga; Ana Maria P. Fernandes Fontes, José Alfredo Lopes Barbosa e Knor Rocha, desenhadores. Fernando Castro, Isabel Fernandes e Ana Bettencourt prestaram colaboração científica nas áreas da Cerâmica Moderna e Pré-história Recente, respetivamente.

Ocorrência de Polypedilum (Tripodura) amataura Bidawid-Kafka, 1996 (Diptera; Chironomidae) em Aquascypha hydrophora (berk.) Reid (Fungi; Stereaceae), com descrição da pupa na Amazônia Central, Brasil

Quatro larvas foram coletadas em água retida pelo fungo Aquascypha hydrophora (Berk.) Reid (Fungi: Stereaceae) fixo em troncos de árvores eretas, na Reserva Florestal Adolpho Ducke, Amazonas, Brasil. Das larvas coletadas, apenas um exemplar desenvolveu até a fase adulta, sendo identificado como Polypedilum (Tripodura) amataura Bidawid-Kafka, 1996. Esta é a primeira descrição para uma forma imatura deste gênero, e também o primeiro registro em micotelmata.

Avaliação da completude do sistema de informação sobre mortalidade por suicídio na região Sudeste, Brasil, no período de 1996 a 2007

OBJETIVO: Analisar a completude dos dados do SIM sobre os óbitos por suicídio no ES, Sudeste e Brasil (1996 a 2007), referentes às variáveis demográficas. MÉTODOS: Estudo descritivo analítico baseado em dados secundários. Foram incluídos os óbitos registrados no SIM por suicídio do Espírito Santo, Sudeste e Brasil. Analisaram-se o número absoluto e o percentual de não preenchimento das variáveis nas declarações de óbito (Dos) por suicídio durante o período. Com a finalidade de avaliar os graus de não completude das variáveis sociodemográficas das DOs, adotou-se escore proposto por pesquisadores. As equações do modelo escolhido e as estatísticas de ajuste para os percentuais de dados faltantes ao longo do tempo (valor de R² e o p-valor do teste F de adequação do modelo) foram obtidas do programa SPSS. O nível de significância adotado foi de 5%. RESULTADOS: As equações dos modelos encontrados indicam que as tendências de não completude para algumas variáveis são crescentes, enquanto para outras são decrescentes e estatisticamente significantes. CONCLUSÃO: As variáveis sexo e idade apresentaram estabilidade nas taxas no ES, Sudeste e Brasil, com melhoras significativas no preenchimento das DOs desses últimos. Quanto às demais variáveis, o ES destacou-se com os piores índices de preenchimento das DOs por suicídio.

Intervenções percutâneas para revascularização do miocárdio no Brasil em 1996 e 1997 comparadas às do biênio 1992 e 1993. Relatório do registro CENIC (Central Nacional de Intervenções Cardiovasculares)

OBJETIVO: Relatar os resultados das intervenções coronárias percutâneas, no Brasil, no biênio 1996-97, comparando-os com os do biênio 1992-93. MÉTODOS: Foram coletados dados relativos a angioplastia com balão (ATC), aterectomia direcionada (AD), aterectomia rotacional (AR), angioplastia com laser (L) e stents coronários (ST). Estes dados foram comparados aos equivalentes, do Registro 1992-93. RESULTADOS: Participaram do registro atual 79% dos sócios titulares da SBHCI, de 127 hospitais, em 1996-97. Foram incluídos 22.025 pacientes, sendo 60,67% submetidos à ATC; 36,57% a ST; 2,3% a AR; 0,06% à AD e 0,4% ao L. A ATC foi o procedimento mais executado, observando-se um aumento relativo do implante de ST, de 1996 para 1997 de 35% (31,1 para 42,1%, p= 0,0001), com concomitante queda na utilização do balão (65,7% para 55,8%, p= 0,0001). A despeito da população de coronarianos tratados, em 1996-97 ser de maior complexidade clínica e anatômica, que a de 1992-93, verificaram-se maiores índices de sucesso do procedimento (89,7% x 92,8%, p= 0,000001), com menor lesão residual (22% x 19%, p= 0,001). Além disto, houve menores índices de complicações maiores: infarto agudo (2,5% x 1,2%, p<0,01), cirurgia de emergência (0,8% x 0,5%, p= 0,002) e óbito (1,8% x 1,4%, p= 0,0003). CONCLUSÃO: Os procedimentos mais executados no último biênio foram: o balão (60,67%) e os stents coronários (36,57%); verificam-se elevados índices de sucesso (92,3%) e baixas taxas de complicações maiores, confirmando o desempenho de excelência da Cardiologia Intervencionista brasileira.

Safety and efficacy of coronary stent implantation. Acute and six month outcomes of 1,126 consecutive patients treated in 1996 and 1997

PURPOSE: The authors analyzed the 30-day and 6-month outcomes of 1,126 consecutive patients who underwent coronary stent implantation in 1996 and 1997. METHODS: The 30-day results and 6-month angiographic follow-up were analyzed in patients treated with coronary stents in 1996 and 1997. All patients underwent coronary stenting with high-pressure implantation (>12 atm) and antiplatelet drug regimen (aspirin plus ticlopidine). RESULTS: During the study period, 1,390 coronary stents were implanted in 1,200 vessels of 1,126 patients; 477 patients were treated in the year 1996 and 649 in 1997. The number of percutaneous procedures performed using stents increased significantly in 1997 compared to 1996 (64 % vs 48%, p=0.0001). The 30-day results were similar in both years; the success and stent thrombosis rates were equal (97% and 0.8%, respectively). The occurrence of new Q wave MI (1.3% vs 1.1%, 1996 vs 1997, p=NS), emergency coronary bypass surgery (1% vs 0.6%, 1996 vs 1997, p=NS) and 30-day death rates (0.2% vs 0.5%, 1996 vs 1997, p=NS) were similar. The 6-month restenosis rate was 25% in 1996 and 27% in 1997 (p= NS); the target vessel revascularization rate was 15% in 1996 and 16% in 1997 (p = NS). CONCLUSIONS: Intracoronary stenting showed a high success rate and a low incidence of 30-day occurrence of new major coronary events in both periods, despite the greater angiographic complexity of the patients treated with in 1997. These adverse variables did not have a negative influence at the 6-month clinical and angiographic follow-up, with similar rates of restenosis and ischemia-driven target lesion revascularization rates.

Acute myocardial infarction in the Brazilian State of São Paulo. In-hospital deaths from 1979 to 1996 and hospital fatality from 1984 to 1998 in the public health system

OBJECTIVE: To determine the following parameters in the Brazilian State of São Paulo: 1) the percentage of deaths due to acute myocardial infarction (AMI) occurring in hospitals; 2) the percentage of deaths due to AMI occurring in public health system hospitals as compared with all in-hospital deaths due to AMI between 1979 and 1996; 3) the fatality due to AMI in public health system hospitals from 1984 to 1998. METHODS: Data were available on the Datasus Web site (the health information agency of the Brazilian Department of Health) that provided the following: a) number of deaths resulting from AMI in hospitals; b) number of deaths resulting from AMI in public health system hospitals; c) number of hospital admissions due to AMI in public health system hospitals. RESULTS: The percentage of in-hospital deaths due to AMI increased from 54.9 in 1979 to 68.6 in 1996. The percentage contribution of the public health system to total number of deaths due to AMI occurring in hospitals decreased from 22.9 in 1984 to 13.7 in 1996; fatality due to AMI occurring in public health system hospitals had an irregular evolution from 1984 to 1992 and showed a slight trend for increased frequency from 1993 to 1998. CONCLUSION: The percentage of in-hospital deaths due to AMI has been increasing. Deaths resulting from AMI in public health system hospitals have decreased when compared with the total number of deaths due to AMI in all hospitals. Fatality due to AMI in public health system hospitals did not decrease from 1992 to 1998.

Mortality attributed to myocardial infarction in the male and female population of Salvador, BA, between 1981 and 1996

OBJECTIVE: To describe according to gender the trend in mortality attributed to myocardial infarction (MI) in the population of Salvador, Bahia between 1981 and 1996. METHODS: This study was on mortality due to MI estimates by period and gender of the city of Salvador, Bahia. Data from 1981 to 1996 were stratified by quadrienia, and the percentage reduction in death rate due to MI relative to the preceding period (PRR) was determined. Comparisons between genders were expressed by the male/female death ratio (DR) based on the gender-related PPR. RESULTS: An overall increase of approximately 8% was observed in the death rate attributed to MI for the period 1985-1988 (89.2/10 5 individuals / year) versus the period 1981-1984 (82.1/10(5)/ year). In the subsequent periods, overall reductions of 10% and 20.3% were observed for the periods 1989-1992 and 1993-1996, respectively. For men, the PPRs were 11.1 in the period 1989-1992 and 22.7% in the period 1993-1996. The PPRs in women were lower: 8.6% and 17.4% between 1989 and 1992, and 1993 and 1996, respectively. Death rate reduction was greater for men than women, then the male/female DR decreased from 1.66 in 1981-1984 to 1.35 in 1993-1996. CONCLUSION: The results indicate a trend towards a reduction in the death rate attributed to myocardial infarction in the city of Salvador from the second half of the 1980s onwards, striking in men.

Trends in death from circulatory diseases in Brazil between 1979 and 1996

OBJECTIVE: To analyze the trends in mortality due to circulatory diseases in men and women aged > or = 30 years in Brazil from 1979 to 1996. METHODS: We analyzed population count data obtained from the IBGE Foundation and mortality data obtained from the System of Information on Mortality of the DATASUS of the Ministry of Health. RESULTS: Circulatory diseases, ischemic heart disease, and cerebrovascular disease were the major causes of death in men and women in Brazil. The standardized age coefficient for circulatory disease in men aged > or = 30 years ranged from 620 to 506 deaths/100,000 inhabitants and in women from 483 to 383 deaths/100,000 inhabitants for the years 1979 and 1996, respectively. In men, the mean coefficient for the period was 586.25 deaths with a significant trend towards a decrease (P<0.001) and a decline of 8.25 deaths/year. In women, the mean coefficient for the period was 439.58 deaths, a significant trend towards a decrease (P<0.001) and a rate of decline of 7.53 deaths/year. The same significant trend towards a decrease in death (P<0.001) was observed for ischemic heart disease and cerebrovascular disease. Risk of death from these causes was always higher for men of any age group (P<0.001). Cerebrovascular disease was the primary cause of death in women. CONCLUSION: Although circulatory diseases have been the major cause of mortality in men and women in the Brazilian population, with a greater participation by cerebrovascular diseases, a trend towards a decrease in the risk of death from these causes is being observed.

Trends in the risk of mortality due to cardiovascular diseases in five Brazilian geographic regions from 1979 to 1996

OBJECTIVE - To analyze the trends in risk of death due to cardiovascular diseases in the northern, northeastern, southern, southeastern, and central western Brazilian geographic regions from 1979 to 1996. METHODS - Data on mortality due to cardiovascular, cardiac ischemic, and cerebrovascular diseases in 5 Brazilian geographic regions were obtained from the Ministry of Health. Population estimates for the time period from 1978 to 1996 in the 5 Brazilian geographic regions were calculated by interpolation with the Lagrange method, based on the census data from 1970, 1980, 1991, and the population count of 1996, for each age bracket and sex. Trends were analyzed with the multiple linear regression model. RESULTS - Cardiovascular diseases showed a declining trend in the southern, southeastern, and northern Brazilian geographic regions in all age brackets and for both sexes. In the northeastern and central western regions, an increasing trend in the risk of death due to cardiovascular diseases occurred, except for the age bracket from 30 to 39 years, which showed a slight reduction. This resulted from the trends of cardiac ischemic and cerebrovascular diseases. The analysis of the trend in the northeastern and northern regions was impaired by the great proportion of poorly defined causes of death. CONCLUSION - The risk of death due to cardiovascular, cerebrovascular, and cardiac ischemic diseases decreased in the southern and southeastern regions, which are the most developed regions in the country, and increased in the least developed regions, mainly in the central western region.

Primary coronary angioplasty in 9,434 patients during acute myocardial infarction: predictors of major in- hospital adverse events from 1996 to 2000 in Brazil

OBJECTIVE: To verify the results after the performance of primary coronary angioplasty in Brazil in the last 4 years. METHODS: During the first 24 hours of acute myocardial infarction onset, 9,434 (12.2%) patients underwent primary PTCA. We analyzed the success and occurrence of major in-hospital events, comparing them over the 4-year period. RESULTS: Primary PTCA use increased compared with that of all percutaneous interventions (1996=10.6% vs. 2000=13.1%; p<0.001). Coronary stent implantation increased (1996=20% vs. 2000=71.9%; p<0.001). Success was greater (1998=89.5% vs. 1999=92.5%; p<0.001). Reinfarction decreased (1998=3.9% vs. 99=2.4% vs. 2000=1.5%; p<0.001) as did emergency bypass surgery (1996=0.5% vs. 2000=0.2%; p=0.01). In-hospital deaths remained unchanged (1996=5.7% vs. 2000=5.1%, p=0.53). Balloon PTCA was one of the independent predictors of a higher rate of unsuccessful procedures (odds ratio 12.01 [CI=95%] 1.58-22.94), and stent implantation of lower mortality rates (odds ratio 4.62 [CI=95%] 3.19-6.08). CONCLUSION: The success rate has become progressively higher with a significant reduction in reinfarction and urgent bypass surgery, but in-hospital death remains nearly unchanged. Coronary stenting was a predictor of a lower death rate, and balloon PTCA was associated with greater procedural failure.

Mortalidade cardiovascular por sexo e faixa etária em São Paulo, Brasil: 1996 a 1998 e 2003 a 2005

FUNDAMENTO: O conhecimento da evolução da mortalidade cardiovascular é importante para levantar hipóteses sobre a sua ocorrência e subsidiar medidas de prevenção e controle. OBJETIVOS: Comparar a mortalidade pelo conjunto das doenças cardiovasculares e seus principais subgrupos: doença isquêmica do coração e cerebrovasculares (DIC e DCBV), no município de São Paulo, por sexo e idade, de 1996 a 1998 e 2003 a 2005. MÉTODOS: Foram usados dados de óbitos do Programa de Aprimoramento das Informações de Mortalidade para o Município (PROAIM) e estimativas populacionais da Fundação Sistema Estadual de Análise de Dados (SEADE) do Estado de São Paulo. A magnitude na mortalidade e as mudanças entre os triênios foram medidas pela descrição de coeficientes e variação percentual relativa. O modelo de regressão de Poisson foi usado também para estimar a mudança na mortalidade entre os períodos. RESULTADOS: Observou-se redução importante da mortalidade cardiovascular. Os coeficientes aumentam com a idade em ambos os sexos. Também são mais elevados na população masculina, na faixa a partir dos 70 anos. Os coeficientes de mortalidade por DIC são maiores que aqueles por DCBV, tanto nos homens como nas mulheres de 50 anos ou mais. O declínio pelo conjunto das doenças cardiovasculares foi maior em mulheres de 20 a 29 anos (-30%) e em homens de 30 a 39 anos (-26%). CONCLUSÃO: A força da intensidade da mortalidade cardiovascular diminuiu entre 1996 e 1998, a 2003 e 2005. Ainda assim há diferenças entre os grupos. Essa redução pode significar, em parte, um maior acesso aos métodos diagnósticos e terapêuticos.