A method based on small area data analysis was developed to build a health risk classification for the Greater Rio de Janeiro Metropolitan Area. The approach uses 1991 census data and studies data pertaining to sanitation, ownership and type of housing, size and occupancy of the household, demography, schooling, and income. Principal component analysis applied over each dimension allowed for the choice of 15 variables, which summarized most of the observed variances. Additional analysis with these variables suggested that just six variables are sufficient for the construction of a classification using k-means method of multivariate cluster analysis. Five classes were obtained: (A) high income; (B) lower income; (C) poor; (D) low schooling and income; (E) low-level access to sanitation. The existing inequality in each of the geopolitical established areas was clearly identified. The proposed method allowed for the construction of compound indices to evaluate quality of life, based on widespread and easily obtained data (the census). Moreover, the method contributed to the detection of socioeconomic inequality, identifying, not only the larger poor regions but also the small excluded areas.
We examined the effect of chronic (15 days) administration of antihypertensive agents, from different pharmacologic classes, on arterial pressure (AP) and heart rate variability in two-kidney, one-clip hypertensive (2K1C) rats. The 2K1C rats received by gavage one of the following: water, ramipril, losartan, atenolol, amlodipine, or hydrochlorothiazide. Sham-operated normotensive rats received water. After 15 days of treatment AP was continuously sampled from an indwelling catheter in awake rats during a 2-h period and systolic AP and pulse interval (PI) were submitted to autoregressive spectral analysis with oscillatory components quantified in low (LF: 0.25 to 0.75 Hz) and high (HF: 0.75 to 3.0 Hz) frequency bands. The AP measured by tail-cuff was 170 +/- 2 mm Hg in 2K1C and 131 +/- 3 mm Hg in normotensive rats. Pooled data indicated that all antihypertensive agents reduced the AP of 2K1C rats to 127 +/- 2 mm Hg, whereas 2K1C rats treated with water remained hypertensive (206 +/- 11 mm Hg). Variance of systolic AP was found increased in 2K1C rats treated with water (34 +/- 2 mm Hg2), whereas 2K1C rats treated with ramipril, atenolol, amlodipine, or hydrochlorothiazide presented AP variance similar to normotensive rats (16 +/- 2 mm Hg2). Losartan normalized AP of 2K1C rats but variance of systolic AP remained increased (34 +/- 7 mm Hg2). The 2K1C rats treated with water had increased LF of systolic AP, whereas 2K1C rats treated with losartan showed higher LF of systolic AP and PI. Atenolol presented lower LF and higher HF of PI. In conclusion, losartan normalized AP but did not reduce AP variability, suggesting an autonomic imbalance characterized by higher sympathetic modulation of the cardiovascular system.
ABSTRACT The major human immunodeficiency virus type 1 subtype circulating in Brazil is B, followed by F and C. We have genotyped 882 samples from Brazilian patients for whom highly active antiretroviral therapy failed, and we found subtype B and the unique recombinant B/F1 forms circulating. Due to codon usage variation, there is a significantly lower incidence of the substitutions L210W, Q151M, and F116Y in subtype F1 isolates than in the subtype B counterparts.
In public health, surveillance is an important issue. To account for the dynamics of diseases in the population, time series methodologies have been used to provide forecasts of future behaviors. Here, we evaluated the use of backpropagation trained multilayer feedforward networks to forecast epidemiological time series. Sixteen different models within this paradigm, differing basically in input layers and training set presentation, were tested and discussed. Six of them produced fair forecasts for the hepatitis B case occurrence in the US time series.
OBJETIVO: Analisar o padrão temporal dos óbitos e internações, no período de 1995 a 1998, associadas à diarréia em crianças menores de cinco anos de idade para subsidiar ações específicas de prevenção e controle dessa doença. MÉTODOS: Os dados foram obtidos do Sistema de Informações sobre Mortalidade (SIM) e Sistema de Internações Hospitalares (SIH) do Ministério da Saúde. As séries mensais de internações e de óbitos por diarréia foram decompostas em componentes de tendência linear estocástica, sazonalidade determinística e irregularidades mediante a aplicação dos modelos estruturais para análise de séries temporais. RESULTADOS: Os níveis de ambas as séries apresentaram mudanças ao longo do tempo, com declínio mais perceptível na série de internações. A variação das taxas de inclinação foi constante para cada uma das séries, em média, a menos 5,3 internações por mês (p-valor <0,001) e menos um óbito por mês (p-valor <0,1), respectivamente. Na análise dos resíduos do modelo de internações, observou-se mudança no nível da tendência em janeiro de 1996. O componente sazonal de ambos os modelos foi estatisticamente significante (p-valor <0,0001), sendo maio e junho os meses com maior excesso de internações e óbitos. Os pressupostos de normalidade e de independência temporal dos resíduos não puderam ser rejeitados ao nível de 0,05. CONCLUSÕES: Os resultados sugerem a predominância da etiologia viral das diarréias moderadas e graves. Neste caso, a vacinação específica é a medida mais eficaz na prevenção e controle, sendo necessários estudos de eficácia de novas candidatas à vacina contra o rotavírus no Brasil.