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1.
PLoS One ; 19(4): e0301937, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38662691

RESUMO

Genomic regions related to tropical adaptability are of paramount importance for animal breeding nowadays, especially in the context of global climate change. Moreover, understanding the genomic architecture of these regions may be very relevant for aiding breeding programs in choosing the best selection scheme for tropical adaptation and/or implementing a crossbreeding scheme. The composite MONTANA TROPICAL® population was developed by crossing cattle of four different biological types to improve production in harsh environments. Pedigree and genotype data (51962 SNPs) from 3215 MONTANA TROPICAL® cattle were used to i) characterize the population structure; ii) identify signatures of selection with complementary approaches, i.e. Integrated Haplotype Score (iHS) and Runs of Homozygosity (ROH); and iii) understand genes and traits related to each selected region. The population structure based on principal components had a weak relationship with the genetic contribution of the different biological types. Clustering analyses (ADMIXTURE) showed different clusters according to the number of generations within the composite population. Considering results of both selection signatures approaches, we identified only one consensus region on chromosome 20 (35399405-40329703 bp). Genes in this region are related to immune function, regulation of epithelial cell differentiation, and cell response to ionizing radiation. This region harbors the slick locus which is related to slick hair and epidermis anatomy, both of which are related to heat stress adaptation. Also, QTLs in this region were related to feed intake, milk yield, mastitis, reproduction, and slick hair coat. The signatures of selection detected here arose in a few generations after crossbreeding between contrasting breeds. Therefore, it shows how important this genomic region may be for these animals to thrive in tropical conditions. Further investigations on sequencing this region can identify candidate genes for animal breeding and/or gene editing to tackle the challenges of climate change.


Assuntos
Polimorfismo de Nucleotídeo Único , Clima Tropical , Animais , Bovinos/genética , Seleção Genética , Adaptação Fisiológica/genética , Montana , Feminino , Genoma , Masculino , Genômica/métodos , Haplótipos , Cruzamento , Genótipo , Carne Vermelha , Locos de Características Quantitativas
2.
Rev. Ciênc. Plur ; 7(3): 158-179, set. 2021. ilus
Artigo em Português | LILACS, BBO - odontologia (Brasil) | ID: biblio-1343520

RESUMO

Introdução:Em saúde pública deve-se considerar dados epidemiológicos e métodos de avaliação da assistência com o intuito de promover melhoria. Nesta perspectiva, há os modelos lógicos que associam atividades, entradas de recursos, saídas de produtos e resultados. Objetivo:Construir um modelo lógico ilustrativo do funcionamento de uma Unidade de Saúde da Família e validar o seu conteúdo. Metodologia:Foi realizada revisão de literatura, observação participante e conversa com informantes-chave. Ademais, houve validação do conteúdo por profissionais atuantes na Unidade de Saúde da Famíliaem uma roda de conversa. Resultados:Elaborou-se cinco dimensões (Gestão do Trabalho, Atividades não assistenciais, Atividades assistenciais, Educação permanente continuada e Atividades docentes assistenciais) relacionadas à missão e aos elementos de recursos (físicos, informação, parcerias e financeiros), caracterizando, assim, o modelo. Conclusões:Os impactos alcançados com a aplicação do modelo remetem a critérios de qualidade (legitimidade, empoderamento e resolutividade); ao modelo assistencial instituído (vigilância à saúde); a características do próprio modelo (Clínica ampliada, intersetorialidade, ações multiprofissionais), além da motivação profissional. Todavia, embora validado por Unidade de Saúde da Famíliaespecífica, o modelo orienta-se por uma Política Nacional, podendo contribuir para outras Unidades de Saúde da Família de diferentes localidades (AU).


Introduction:In public health, in order to improve quality, epidemiological data and methods for evaluation of care should be considered. Logical models that associate activities, expenditure of resources, output of products, and results can be a useful assessment tool. Objective:To designand validate a logical model representingthe operationof a Family HealthcareUnit. Methodology:A literature review was initially performed, followed by participant observation and conversation with key informants. In addition, model was validated by professionals working at the Family HealthcareUnit (FHU) in a conversation roundtable. Results:Five dimensions were conceived: Work management;Noncare-related activities;Care-related activities; Permanent education;and In-service teaching, which relate to the mission of the service and the relevant resources (physical, information, partnerships and financial), thus constituting the model. Conclusions:The impacts achieved with the application of the model concernthe quality criteria (legitimacy, empowerment andproblem-solving capacity); the instituted healthcare model (active surveillance); features of the model itself (extended clinic, intersectoriality, multiprofessional actions); as well as professional motivation. Although themodel was validated only in a local Health Center, it follows a National Policy and may contribute to quality improvement of other Health Centersfrom different areas (AU).


Introducción: En salud pública, se deben considerar los datos epidemiológicos y los métodos de evaluación de la atención para promover la mejora. En esta perspectiva, existen modelos lógicos que asocian actividades, insumos de recursos, productos y resultados.Objetivo: Construir un modelo lógico que ilustre el funcionamiento de una unidad de salud familiar y validar su contenido. Metodología: Se realizó una revisión de la literatura, observación participante y conversación con informantes clave. Además, el contenido fue validado por profesionales que trabajan en la Unidad de Salud Familiar (FHU) en un círculo de conversación. Resultados: Se elaboraron cinco dimensiones (gestión del trabajo, actividades de no asistencia, actividades de asistencia, educación continua y actividades de asistencia a la enseñanza) relacionadas con la misión y los elementos de los recursos (físicos, de información, asociaciones y financieros), caracterizando, así, la modelo. Conclusiones: Los impactos logrados con la aplicación del modelo se refieren a criterios de calidad (legitimidad, empoderamiento y resolución); el modelo de atención establecido (vigilancia de la salud); las características del modelo en sí (clínica ampliada, intersectorialidad, acciones multiprofesionales), además de la motivación profesional. Sin embargo, aunque validado por una Centro de Saludespecífica, el modelo está guiado por una Política Nacional y puede contribuir a otrasCentros de Saludem diferentes ubicaciones (AU).


Assuntos
Avaliação em Saúde , Saúde da Família , Mecanismos de Avaliação da Assistência à Saúde , Pesquisa sobre Serviços de Saúde/métodos , Brasil/epidemiologia , Pesquisa Qualitativa , Estudos de Avaliação como Assunto
3.
BMC Pediatr ; 20(1): 511, 2020 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-33160309

RESUMO

BACKGROUND: Reports suggest that Latin American and Caribbean (LAC) countries have not reduced leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000-2017 and predicted mortality to 2030. METHODS: We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013-2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030. RESULTS: Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by - 9.7%), and girls (EAPC by - 6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030. CONCLUSION: Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.


Assuntos
Leucemia , Argentina , Criança , Equador , Feminino , Guatemala , Humanos , América Latina/epidemiologia , Masculino , México , Mortalidade , Nicarágua/epidemiologia , Panamá , Peru/epidemiologia , Venezuela
4.
Ticks Tick Borne Dis ; 11(6): 101519, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32993939

RESUMO

Gram-negative spirochetes of the genus Borrelia are transmitted to vertebrate hosts through the tick bite during blood intake. Pathogenic Borrelia species may cause relapsing fever or Lyme borreliosis in humans. Our study aimed to molecularly detect and characterize bacteria of this genus in ticks collected in the Iguaçu National Park, located in southern Brazil. Ticks were collected from the environment (free living) and from hosts from May 2015 to July 2017. In total, 829 ticks were tested, being 741 from the environment and 88 from hosts; 128 ticks were larvae, 523 were nymphs, and 178 were adults (80 males and 98 females). The species identified were: Amblyomma brasiliense (42.9 %), Amblyomma coelebs (16.8 %), Amblyomma sp. (15.0 %), Amblyomma incisum (10.3 %), Amblyomma ovale (8.7 %), Haemaphysalis juxtakochi (5.5 %), Rhipicephalus microplus (0.5 %), Amblyomma longirostre (0.2 %), and Rhipicephalus sanguineus sensu lato (0.1 %). DNA extraction was performed with pools of larvae or nymphs, or individually with adults, for a total of 394 samples. The PCR technique used to detect Borrelia DNA was performed with two rounds of amplification reactions targeting a segment of the flagellin B gene (flaB). Amplification occurred in only one DNA sample, which was obtained from nymphs of A. brasiliense collected from the vegetation of a trail. The nucleotide sequence analysis revealed 90.8 % identity to a sequence of Borrelia sp. from Côte d'Ivoire, and 89.1 % identity to a sequence from Ethiopia. Phylogenetic analysis revealed that the Borrelia sequence from A. brasiliense was distinct from the Borrelia species of the groups belonging to Lyme borreliosis, relapsing fever and the one associated with reptile and echidna as hosts. The sequence is likely from a putative new species of Borrelia and was detected for the first time in A. brasiliense ticks.


Assuntos
Amblyomma/microbiologia , Borrelia/classificação , Amblyomma/crescimento & desenvolvimento , Sequência de Aminoácidos , Animais , Sequência de Bases , Borrelia/genética , Brasil , Ninfa/crescimento & desenvolvimento , Ninfa/microbiologia , Parques Recreativos , Filogenia , Alinhamento de Sequência
5.
Asian Pac J Cancer Prev ; 21(4): 919-926, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32334451

RESUMO

BACKGROUND AND OBJECTIVE: This was a population-based ecological with data of deaths from the Mortality Information System. The objective of this study was to analyze the temporal trends of mortality induced by bronchi and lung cancer in Brazil and its geographical regions between 2001 and 2015 and secondly to calculate predictions for 2016-2030. MATERIAL AND METHODS: The mortality trends were analyzed by the Joinpoint regression and calculation of predictions was used the Nordpred software. RESULTS: There was a reduction trend in lung cancer mortality among Brazilian men living in South and Southeast regions of Brazil. However, there was an increasing trend in lung cancer mortality among Brazilian women living in Northeast, Southeast, and South regions of Brazil. When comparing the last observed period and the last foreseen period for males, it is expected an increase of 12.86% in the number of deaths, justified mainly by the change in population structure, with a reduction in the risk of death by the disease. For women, the expected increase is 26.22%, justified both by population structure, and the increased risk of deaths from the disease. The higher rates will be observed in the southern region of the country, for both sexes. CONCLUSION: The mortality induced by lung and bronchial cancer in Brazil was unevenly distributed. However lung cancer incidence had a reducing trend, the mortality caused following it was increased among men. For women, the rates are rising, and until 2030, the mortality load will continue to rise for both.
.


Assuntos
Neoplasias Pulmonares/mortalidade , Mortalidade/tendências , Fatores Socioeconômicos , Adolescente , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Demografia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida , Adulto Jovem
6.
Cien Saude Colet ; 24(4): 1551-1561, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31066856

RESUMO

Melanoma is the main serious skin cancer, due to its high lethality. This study aimed to make projections and analyze melanoma mortality trends in Brazil. Mortality Information System data were utilized for the period 1998-2012, which were projected until 2032, using the age-period-cohort model, with software R. The analysis of trends was made by Joinpoint regression, with 95% confidence interval, estimating the annual percentage change. It was revealed higher amounts of deaths in men for all regions. Brazilian trends presented reductions in men (APC = -0.4; CI95% = -0.6; -0.1; p < 0.01) and in women (APC = -0.8; CI95% = -0.9; -0.7; p < 0.01). The Midwest region presented increases for both sexes, while the Southeast region presented reducing trends for both sexes. In the North, there was stability for men and increases followed by stability in women, while the South presented reductions in men and stability in women; finally, the Northeast revealed one joinpoint per sex, with an increase followed by stability in men, and stability followed by reducing trends in women. The highest rates of the country were found in the South and Southeast regions, however, with reducing trends throughout time. Higher mortality trends in men were associated with later diagnoses in this group.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Sistemas de Informação , Masculino , Melanoma/mortalidade , Pessoa de Meia-Idade , Mortalidade/tendências , Distribuição por Sexo , Neoplasias Cutâneas/mortalidade , Adulto Jovem
7.
Ciênc. Saúde Colet. (Impr.) ; 24(4): 1551-1561, abr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1001778

RESUMO

Abstract Melanoma is the main serious skin cancer, due to its high lethality. This study aimed to make projections and analyze melanoma mortality trends in Brazil. Mortality Information System data were utilized for the period 1998-2012, which were projected until 2032, using the age-period-cohort model, with software R. The analysis of trends was made by Joinpoint regression, with 95% confidence interval, estimating the annual percentage change. It was revealed higher amounts of deaths in men for all regions. Brazilian trends presented reductions in men (APC = -0.4; CI95% = -0.6; -0.1; p < 0.01) and in women (APC = -0.8; CI95% = -0.9; -0.7; p < 0.01). The Midwest region presented increases for both sexes, while the Southeast region presented reducing trends for both sexes. In the North, there was stability for men and increases followed by stability in women, while the South presented reductions in men and stability in women; finally, the Northeast revealed one joinpoint per sex, with an increase followed by stability in men, and stability followed by reducing trends in women. The highest rates of the country were found in the South and Southeast regions, however, with reducing trends throughout time. Higher mortality trends in men were associated with later diagnoses in this group.


Resumo O melanoma é o mais grave câncer de pele, devido à alta letalidade. Este estudo objetiva projetar e analisar tendências da mortalidade por melanoma no Brasil. Os dados são do Sistema de Informação sobre Mortalidade, no período de 1998 a 2012, os quais foram projetados até 2032, usando o modelo idade-período-coorte, no software R . A análise de tendências foi feita pela Regressão loglineal ( Joinpoint regression ), com intervalo de confiança de 95%, para estimar a porcentagem anual de mudança. Revelou-se maior quantitativo de mortes em homens em todas as regiões. As tendências no Brasil apontaram para redução em homens (APC = -0,4; IC95% = -0,6; -0,1; p < 0,01) e em mulheres (APC = -0,8; IC95% = -0,9; -0,7; p < 0,01). A região Centro-oeste teve aumento para os dois sexos, em oposição ao Sudeste, com redução em ambos. No Norte, houve estabilidade em homens, e aumento seguido de estabilidade em mulheres, enquanto o Sul teve redução em homens e estabilidade em mulheres; e, por fim, o Nordeste teve um joinpoint em cada sexo, com aumento seguido de estabilidade em homens; e estabilidade seguida de redução em mulheres. As maiores taxas do país foram no Sul e Sudeste, todavia, com tendência a redução ao longo do tempo. A maior mortalidade em homens foi associada ao diagnóstico mais tardio.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Cutâneas/epidemiologia , Melanoma/epidemiologia , Neoplasias Cutâneas/mortalidade , Brasil/epidemiologia , Sistemas de Informação , Mortalidade/tendências , Distribuição por Sexo , Distribuição por Idade , Previsões , Melanoma/mortalidade , Pessoa de Meia-Idade
8.
Arq Gastroenterol ; 55(3): 230-236, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30540083

RESUMO

BACKGROUND: Pancreatic cancer is one of the main cancer-related causes of death in developed countries, and one of the most lethal malignant neoplasms. This type of cancer is classified as the ninth most frequent in the world. OBJECTIVE: Analyze temporal trends for pancreatic cancer in Brazil in the period 2000-2014 and calculate mortality projections for the period 2015-2029. METHODS: Ecological study, with temporal series, based on information provided by the Brazilian Mortality Information System. Analysis included deaths due to pancreatic malignant neoplasms in Brazil in the period 2000-2014, and analyzed according to sex, age group and Brazilian geographic regions. Projections were made until 2029 in five-year periods, calculated in Nordpred (within the R software). Mortality trends were analyzed by Joinpoint regression. RESULTS: Between 2000 and 2014, there were 112,533 deaths due to pancreatic cancer in Brazil. Age-standardised rates was 5.1 deaths/100,000 men and 3.81 deaths/100,000 women. The highest rates were registered for the Midwest region, for both genders. Projections indicated that for the five-year period 2025-2029 there will be increased mortality rates for men in the Northeast and Midwest regions. Joinpoint analysis for Brazil did not reveal significant increases for women (APC=0.4%; 95% CI: -0.2; 1.0), however, there was a significant increasing mortality trend for men (APC= 3.7%; 95% CI: 0.6-7.0) in the period 2000-2004, followed by a stable period, an then another period of significant increases after 2010. These figures are mostly explained by variations in the Brazilian demographic structure. CONCLUSION: Pancreatic cancer mortality is unequally distributed across Brazilian regions and genders, and during the next two decades the differences will be accentuated.


Assuntos
Neoplasias Pancreáticas/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Previsões , Geografia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Valores de Referência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Análise Espaço-Temporal , Fatores de Tempo , Adulto Jovem
9.
Arq. gastroenterol ; 55(3): 230-236, July-Sept. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-973885

RESUMO

ABSTRACT BACKGROUND: Pancreatic cancer is one of the main cancer-related causes of death in developed countries, and one of the most lethal malignant neoplasms. This type of cancer is classified as the ninth most frequent in the world. OBJECTIVE: Analyze temporal trends for pancreatic cancer in Brazil in the period 2000-2014 and calculate mortality projections for the period 2015-2029. METHODS: Ecological study, with temporal series, based on information provided by the Brazilian Mortality Information System. Analysis included deaths due to pancreatic malignant neoplasms in Brazil in the period 2000-2014, and analyzed according to sex, age group and Brazilian geographic regions. Projections were made until 2029 in five-year periods, calculated in Nordpred (within the R software). Mortality trends were analyzed by Joinpoint regression. RESULTS: Between 2000 and 2014, there were 112,533 deaths due to pancreatic cancer in Brazil. Age-standardised rates was 5.1 deaths/100,000 men and 3.81 deaths/100,000 women. The highest rates were registered for the Midwest region, for both genders. Projections indicated that for the five-year period 2025-2029 there will be increased mortality rates for men in the Northeast and Midwest regions. Joinpoint analysis for Brazil did not reveal significant increases for women (APC=0.4%; 95% CI: -0.2; 1.0), however, there was a significant increasing mortality trend for men (APC= 3.7%; 95% CI: 0.6-7.0) in the period 2000-2004, followed by a stable period, an then another period of significant increases after 2010. These figures are mostly explained by variations in the Brazilian demographic structure. CONCLUSION: Pancreatic cancer mortality is unequally distributed across Brazilian regions and genders, and during the next two decades the differences will be accentuated.


RESUMO CONTEXTO: O câncer de pâncreas é uma das principais causas de morte relacionadas ao câncer em países desenvolvidos, e uma das neoplasias malignas mais letais. Este tipo de câncer é classificado como o nono mais frequente do mundo. OBJETIVO: Analisar as tendências temporais do câncer de pâncreas no Brasil no período de 2000-2014, e calcular as projeções de mortalidade para o período de 2015-2029. MÉTODOS: Estudo ecológico, de séries temporais, baseado em informações advindas do Sistema de Informações sobre Mortalidade brasileiro. A análise incluiu os óbitos por neoplasias malignas pancreáticas no Brasil, no período de 2000 a 2014, avaliados segundo sexo, faixa etária e regiões geográficas brasileiras. As projeções foram feitas até 2029, em períodos de cinco anos, calculados no Nordpred (no software R). E as tendências de mortalidade foram analisadas por regressão Joinpoint. RESULTADOS: Entre 2000 e 2014, ocorreram 112.533 mortes por câncer de pâncreas no Brasil. A taxa padronizada foi de 5,1 mortes /100.000 homens e 3,81 mortes /100.000 mulheres. As maiores taxas foram registradas para a região Centro-Oeste, para os dois gêneros. As projeções indicaram que, para o quinquênio 2025-2029, haverá aumento nas taxas de mortalidade de homens nas regiões Nordeste e Centro-Oeste. A análise do joinpoint para o Brasil não revelou aumento significativo para as mulheres (APC=0,4%; IC95%: -0,2; 1,0), entretanto, houve um aumento significativo da tendência de mortalidade para homens (APC=3,7%; IC95%: 0,6-7,0) no período 2000-2004, seguido de um período de estabilidade e, em seguida, aumento significativo após 2010. Esses resultados são explicados principalmente por variações na estrutura demográfica brasileira. CONCLUSÃO: A mortalidade por câncer de pâncreas está distribuída de forma desigual nas regiões e gêneros brasileiros e, nas próximas duas décadas, as diferenças serão acentuadas.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Idoso , Adulto Jovem , Neoplasias Pancreáticas/mortalidade , Valores de Referência , Fatores Socioeconômicos , Fatores de Tempo , Brasil/epidemiologia , Fatores Sexuais , Fatores de Risco , Mortalidade/tendências , Fatores Etários , Medição de Risco , Análise Espaço-Temporal , Previsões , Geografia , Pessoa de Meia-Idade
10.
PLoS One ; 13(3): e0193135, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29554098

RESUMO

The main objective of the study was to analyze the effect of age, period and birth cohort on esophageal cancer mortality in Brazil and its geographic regions, per sex. An ecological study is presented herein, which evaluated the deaths by esophageal cancer and the distribution, per geographic region. Poisson Regression was utilized to calculate the effects of age, period and birth cohort, and projections were made with the statistical software R, using the age-period-cohort model. Projection of data covered the period 2015-2029. Regarding the geographic regions of Brazil, a decrease was verified, throughout time, for the mortality rates of the South and Southeast regions, for men and women. For the North, Northeast and Midwest regions, an increase was evidenced in mortality rates, mainly for men, after the 2000's. Regarding the projections, a progressive increase of mortality rates was verified for the Northeast and North regions. Divergences evidenced for observed and projected esophageal cancer mortality rates revealed inequalities among the geographic regions of Brazil.


Assuntos
Neoplasias Esofágicas/mortalidade , Modelos Biológicos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mortalidade , Fatores Socioeconômicos
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