Revision of Neotropical wolf spider genus Arctosa C.L. Koch, 1847 (Araneae: Lycosidae), with description of seven new species.

The genus Arctosa C.L. Koch is redescribed and diagnosed. Seven new species are described, four of them based on both sexes (A. conflicta sp. nov., A. costenola sp. nov., A. jibarosa sp. nov. and A. villa sp. nov.), two only on females (A. ayaymama sp. nov. and A. mineira sp. nov.), and one only on the male (A. pacaya sp. nov.). We also propose the transference of Arctosa humicola (Bertkau, 1880) and Arctosa fusca (Keyserling, 1877) to Trochosa C.L. Koch, 1847, and the new synonymy of Arctosa inconspicua (Bryant, 1948) with Trochosa humicola (Bertkau, 1880) comb. nov. Besides, Arctosa andina (Chamberlin, 1916) and Arctosa pugil (Bertkau, 1880) are transferred to Hogna Simon, 1885, and Arctosa aussereri (Keyserling, 1877) to Prolycosides Mello-Leito, 1942. Additionally, eight lycosid species are synonymized with Prolycosides aussereri: Schizocosa proletaria (Tullgren, 1905); Arctosa workmani (Strand, 1909); Hogna planithoracis (Mello-Leito, 1938); Hogna variolosa (Mello-Leito, 1941); Megarctosa melanostoma (Mello-Leito, 1941); Hippasosa huachoi (Mello-Leito, 1942); Pirata abalosi (Mello-Leito, 1942); and Pirata soukupi (Mello-Leito, 1942). We also transfer Trochosa tenebrosa Keyserling, 1877 to Arctosa. The males of Arctosa tenebrosa (Keyserling, 1877) comb. nov. and Trochosa humicola (Bertkau, 1880) comb. nov. are described for the first time.

Taxonomic revision of the jumping spider genus Tullgrenella Mello-Leito, 1941 (Araneae: Salticidae: Freyina).

This paper presents a taxonomic revision of the genus Tullgrenella Mello-Leito, 1941. Four new species are described: Tullgrenella aisenbergae Marta, sp. nov. (Brazil) (), T. legalissima Marta & Hagopin sp. nov. (Uruguay) (), T. galianoae Marta, sp. nov. (Brazil) () and T. sciosciae Marta & Bustamante sp. nov. (Brazil) (). The males of T. corrugata Galiano, 1981 and T. peniaflorensis Galiano, 1970, and the female of T. selenita Galiano, 1970 are described for the first time. An updated diagnosis for the genus is provided based on the detailed comparative morphological studies. In addition, we present a proposal and discussion about the species groups of Tullgrenella based on the putative synapomorphies as well as the updated distribution of the genus in South America.

Revision of Neotropical wolf spider genus Arctosa C.L. Koch, 1847 (Araneae: Lycosidae), with description of seven new species

The genus Arctosa C.L. Koch is redescribed and diagnosed. Seven new species are described, four of them based on both sexes (A. conflicta sp. nov., A. costenola sp. nov., A. jibarosa sp. nov. and A. villa sp. nov.), two only on females (A. ayaymama sp. nov. and A. mineira sp. nov.), and one only on the male (A. pacaya sp. nov.). We also propose the transference of Arctosa humicola (Bertkau, 1880) and Arctosa fusca (Keyserling, 1877) to Trochosa C.L. Koch, 1847, and the new synonymy of Arctosa inconspicua (Bryant, 1948) with Trochosa humicola (Bertkau, 1880) comb. nov. Besides, Arctosa andina (Chamberlin, 1916) and Arctosa pugil (Bertkau, 1880) are transferred to Hogna Simon, 1885, and Arctosa aussereri (Keyserling, 1877) to Prolycosides Mello-Leitão, 1942. Additionally, eight lycosid species are synonymized with Prolycosides aussereri: Schizocosa proletaria (Tullgren, 1905); Arctosa workmani (Strand, 1909); Hogna planithoracis (Mello-Leitão, 1938); Hogna variolosa (Mello-Leitão, 1941); Megarctosa melanostoma (Mello-Leitão, 1941); Hippasosa huachoi (Mello-Leitão, 1942); Pirata abalosi (Mello-Leitão, 1942); and Pirata soukupi (Mello-Leitão, 1942). We also transfer Trochosa tenebrosa Keyserling, 1877 to Arctosa. The males of Arctosa tenebrosa (Keyserling, 1877) comb. nov. and Trochosa humicola (Bertkau, 1880) comb. nov. are described for the first time.

Taxonomic revision of the jumping spider genus Tullgrenella Mello-Leitão, 1941 (Araneae: Salticidae: Freyina)

This paper presents a taxonomic revision of the genus Tullgrenella Mello-Leitão, 1941. Four new species are described: Tullgrenella aisenbergae Marta, sp. nov. (Brazil) (♂♀), T. legalissima Marta & Hagopián sp. nov. (Uruguay) (♀), T. galianoae Marta, sp. nov. (Brazil) (♂♀) and T. sciosciae Marta & Bustamante sp. nov. (Brazil) (♂♀). The males of T. corrugata Galiano, 1981 and T. peniaflorensis Galiano, 1970, and the female of T. selenita Galiano, 1970 are described for the first time. An updated diagnosis for the genus is provided based on the detailed comparative morphological studies. In addition, we present a proposal and discussion about the species groups of Tullgrenella based on the putative synapomorphies as well as the updated distribution of the genus in South America.

Cardiovascular Statistics ­ Brazil 2023 / Estatística Cardiovascular ­ Brasil 2023

The publication Cardiovascular Statistics ­ Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.  The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.  Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG). 

A publicação Estatística Cardiovascular ­ Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.  Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG). 

Prevalence of adult smokers in Brazilian capitals according to socioeconomic deprivation.

OBJECTIVE: To estimate the prevalence of adult smokers in the 26 capitals and the Federal District according to the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). METHODS: Dataset on smoking were obtained from the Surveillance of Risk and Protective Factors for Noncommunicable Diseases by Survey (Vigitel) system for the 26 capitals and the Federal District, in the period from 2010 to 2013. The IBP classifies the census sectors according to indicators such as: income less than ½ minimum wage, illiterate population and without sanitary sewage. In the North and Northeast regions, the census sectors were grouped into four categories (low, medium, high and very high deprivation) and in the South, Southeast and Midwest regions into three (low, medium and high deprivation). Prevalence estimates of adult smokers were obtained using the indirect estimation method in small areas. To calculate the prevalence ratios, Poisson models are used. RESULTS: The positive association between prevalence and deprivation of census sector categories was found in 16 (59.3%) of the 27 cities. In nine (33.3%) cities, the sectors with the greatest deprivation had a higher prevalence of smokers when compared to those with the least deprivation, and in two (7.4%) there were no differences. In Aracaju, Belém, Fortaleza, João Pessoa, Macapá and Salvador, the prevalence of adult smokers was three times higher in the group of sectors with greater deprivation compared to those with less deprivation. CONCLUSION: Sectors with greater social deprivation had a higher prevalence of smoking, compared with less deprivation, pointing to social inequalities.

Taxonomic review of the Andean crab spiders genus Coenypha Simon, 1895 (Thomisidae: Stephanopinae).

The genus Coenypha Simon, 1895 is composed of species distributed on the Southern Andean Region and Patagonia, and presents remarkable somatic morphologies, such as the flattened habitus, enlarged femora I, and a wide opisthosoma. Molecular and morphology-based phylogenies have revealed the close relationship of this genus with sympatric species previously assigned to Stephanopis O. Pickard-Cambridge, 1869. Our recent cladistic analysis extended such preliminary results in recovering numerous morphological characters as synapomorphies of a well-supported clade, thus justifying the transfer of all species of 'Andean Stephanopis' to Coenypha. In the present work, we provide a taxonomic review of these species, update their diagnoses, descriptions and illustrate them through detailed photographs. New distribution records are presented, the male of C. antennata (Tullgren, 1902) is described for the first time, and two new species are described based on both sexes (Coenypha trapezium sp. nov. and Coenypha foliacea sp. nov.). Stephanopis exigua (Nicolet, 1849) is considered a nomen dubium. Stephanopis verrucosa (Nicolet, 1849), Thomisus spectrum Nicolet, 1849, and T. pubescens Nicolet, 1849 are synonymized with Coenypha nodosa (Nicolet, 1849). The synonymy of Thomisus nicoleti Roewer, 1951 (a replaced name for T. cinereus Nicolet, 1849 due to a homonymy) with Misumenops temibilis (Holmberg, 1876) is rejected, and considered together with Stephanopis spissa (Nicolet, 1849), Thomisus variabilis Nicolet, 1849 and Stephanopis maulliniana Mello-Leitão, 1951, synonyms of Coenypha ditissima (Nicolet, 1849); Stephanopis badia Keyserling, 1880 is transferred to Sidymella Strand, 1942.

Tidying things up: Tropicosa, a new Neotropical wolf spider genus (Araneae: Lycosidae: Lycosinae).

The new genus Tropicosa is proposed based on species of some controversial Neotropical genera of lycosids. These spiders present a longitudinal dark stripe over the sternum in both sexes, median apophysis sinuous, tegular lobe evidently sclerotized and the epigyne with median septum anteriorly expanded and with a parallel, triangular hood. We transfer Alopecosa moesta (Holmberg), Schizocosa chelifasciata (Mello-Leitão) and Lycosa thorelli (Keyserling) to Tropicosa gen. nov. and describe one new species, Tropicosa baguala sp. nov. Likewise, Arctosa bogotensis (Keyserling) is synonymized with Tropicosa thorelli (Keyserling) comb. nov., and Lycosa langei Mello-Leitão with T. chelifasciata (Mello-Leitão) comb. nov. based on examined types. All the four species proposed as members of Tropicosa gen. nov. have South American distribution.

Implementation of the 7-1-7 target for detection, notification, and response to public health threats in five countries: a retrospective, observational study.

BACKGROUND: Suboptimal detection and response to recent outbreaks, including COVID-19 and mpox (formerly known as monkeypox), have shown that the world is insufficiently prepared for public health threats. Routine monitoring of detection and response performance of health emergency systems through timeliness metrics has been proposed to evaluate and improve outbreak preparedness and contain health threats early. We implemented 7-1-7 to measure the timeliness of detection (target of ≤7 days from emergence), notification (target of ≤1 day from detection), and completion of seven early response actions (target of ≤7 days from notification), and we identified bottlenecks to and enablers of system performance. METHODS: In this retrospective, observational study, we conducted reviews of public health events in Brazil, Ethiopia, Liberia, Nigeria, and Uganda with staff from ministries of health and national public health institutes. For selected public health events occurring from Jan 1, 2018, to Dec 31, 2022, we calculated timeliness intervals for detection, notification, and early response actions, and synthesised identified bottlenecks and enablers. We mapped bottlenecks and enablers to Joint External Evaluation (second edition) indicators. FINDINGS: Of 41 public health events assessed, 22 (54%) met a target of 7 days to detect (median 6 days [range 0-157]), 29 (71%) met a target of 1 day to notify (0 days [0-24]), and 20 (49%) met a target of 7 days to complete all early response actions (8 days [0-72]). 11 (27%) events met the complete 7-1-7 target, with variation among event types. 25 (61%) of 41 bottlenecks to and 27 (51%) of 53 enablers of detection were at the health facility level, with delays to notification (14 [44%] of 32 bottlenecks) and response (22 [39%] of 56 bottlenecks) most often at an intermediate public health (ie, municipal, district, county, state, or province) level. Rapid resource mobilisation for responses (six [9%] of 65 enablers) from the national level enabled faster responses. INTERPRETATION: The 7-1-7 target is feasible to measure and to achieve, and assessment with this framework can identify areas for performance improvement and help prioritise national planning. Increased investments must be made at the health facility and intermediate public health levels for improved systems to detect, notify, and rapidly respond to emerging public health threats. FUNDING: Bill & Melinda Gates Foundation.

Programa de exercícios físicos por telerreabilitação em idosos com doença de Parkinson: um estudo experimental / Telerehabilitation exercise program in elderly people with Parkinson's disease: an experimental study

INTRODUÇÃO: As restrições durante a pandemia do COVID-19 limitaram o acesso a centros de reabilitação especializados para tratamento fisioterapêutico de pessoas com Doença de Parkinson (DP). Sabe-se que a falta de exercícios físicos pode agravar as condições de saúde, levar à piora dos sinais típicos da doença e promover o declínio funcional. A telerreabilitação é uma estratégia que pode restaurar o acesso e facilitar a continuidade de assistência fisioterapêutica. OBJETIVOS: Avaliar os efeitos de um programa de exercícios físicos por telerreabilitação no nível de atividade física, no desempenho funcional de Membros Inferiores (MMII), no desempenho nas atividades de vida diária (AVD's) e na qualidade de vida (QV) em idosos com DP. MATERIAIS E MÉTODOS: Trata-se de um estudo experimental, descritivo, longitudinal, em que foram avaliados os efeitos da intervenção por telerreabilitação composta por 12 sessões de 1 hora, feitas 3 vezes/semana, realizada estatística analítica para fins comparativos pelo Teste t de Student. RESULTADOS: 22 participantes concluíram o estudo. Foi observada mudança significativa no nível de atividade física (IPAQ inicial de 0,18 ±0,39 e final de 1,0 ± 0, p = 0,0001), no desempenho funcional dos MMII (teste de sentar e levantar cinco vezes (TSLCV) tempo médio pré 16,22 ± 7.41, e após 12.26 ± 2.83, p= 0,0197), no desempenho nas atividades de vida diária (Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ) de 26,13 ± 6,31 e após de 35,45 ± 5,16, p = 0,0001) e na QV dos idosos com DP (PDQ-39 inicial de 45,92 ±15,36 e final de 23,63 ± 10,19, p = 0,0001). CONCLUSÃO: Concluise que houve mudança no nível de atividade física, no desempenho funcional de MMII, no desempenho nas AVD's e na QV.

INTRODUCTION: Restrictions during the COVID-19 pandemic limited access to specialized rehabilitation centers for physical therapy treatment of people with Parkinson's disease (PD). It is known that lack of exercise can worsen health conditions, lead to worsening typical signs of the disease, and promote functional decline. Telerehabilitation is a strategy that can restore access and facilitate the continuity of physical therapy care. OBJECTIVES: To evaluate the effects of a telerehabilitation exercise program on the level of physical activity, functional capacity of lower limbs, performance of activities of daily living (ADLs) and quality of life (QoL) in elderly patients with PD. MATERIALS AND METHODS: This is an experimental, descriptive, exploratory, longitudinal study, in which the effects of intervention by telerehabilitation were evaluated, the program was composed of 12 sessions of 1 hour, 3 times a week. Analytical statistics was done for comparative purposes by Student's t test. RESULTS: 22 participants completed the study. Significant change was observed in physical activity level (IPAQ initial 0.18 ±0.39 and final 1.0 ± 0, p = 0.0001), in the functional capacity of lower limbs (5 times sit and stand test (TSLCV) mean time pre 16.22 ± 7.41, and post 12.26 ± 2. 83, p= 0.0197), in the performance in the activities of daily living (Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ) of 26.13 ± 6.31 and after of 35.45 ± 5.16, p = 0.0001) and in the QL of the elderly with PD (PDQ-39 initial of 45.92 ±15.36 and final of 23.63 ± 10.19, p = 0.0001). CONCLUSION: We conclude that there was a change in the level of physical activity, in the functional capacity of lower limbs, in the performance of ADLs and in QL.

The Spittlebug Mahanarva tristis as a Senior Synonymy of Four Neotropical Species of Mahanarva (Hemiptera: Auchenorrhyncha: Cercopidae), and Considerations About M. tristis Subspecies.

Mahanarva Distant, the neotropical spittlebug genus contains 48 species and many of them are only known from their original descriptions and one location. A group of species of this genus stand out due to their similarities and are studied here. Based on comparisons between 28 Mahanarva tristis (Fabricius) specimens and the original drawings of the other species, we demonstrate strong morphological similarities. Examinations of the tegmina showed a polymorphism with different dot and stripe patterns. Those patterns are not exclusive for one species and are found throughout the taxa. Again, studying the male genitals no species-specific characters can be found. Furthermore, differences of the parameres were explained by different angle positions of these genital plates which alter the resulting photos and drawings significantly. On the other hand, changes of the aedeagus can be explained due to its fragile structure and the resulting manipulations during handling. In addition, the overlapping known distribution of the taxa leads to the conclusion that the four species are in fact synonyms of M. tristis and that there is no evidence for the validity of the subspecies. We conclude that the New World spittlebug M. tristis is considered a senior synonym of Mahanarva fraseri (Distant) n. syn., Mahanarva mura (China & Myers) n. syn., Mahanarva raripila (Jacobi) n. syn., and Mahanarva trifissa (Jacobi) n. syn. Aside from that, there was no evidence for the validity of the M. tristis subspecies Mahanarva tristis guppyi (Urich) n. syn., Mahanarva tristis monagasi (Fennah) n. syn., Mahanarva tristis quadrimaculata (Fennah) n. syn., Mahanarva tristis suffusa (Walker) n. syn., and Mahanarva tristis walkeri (Lallemand) n. syn. Unfortunately, it was not possible to conclude the taxonomic state of Mahanarva tristis stalii (Lallemand) because there are no known specimens or types available. So, the subspecies is considered a species inquirenda.

Tidying things up: tropicosa, a new neotropical wolf spider genus (Araneae: Lycosidae: Lycosinae)

The new genus Tropicosa is proposed based on species of some controversial Neotropical genera of lycosids. These spiders present a longitudinal dark stripe over the sternum in both sexes, median apophysis sinuous, tegular lobe evidently sclerotized and the epigyne with median septum anteriorly expanded and with a parallel, triangular hood. We transfer Alopecosa moesta (Holmberg), Schizocosa chelifasciata (Mello-Leitão) and Lycosa thorelli (Keyserling) to Tropicosa gen. nov. and describe one new species, Tropicosa baguala sp. nov. Likewise, Arctosa bogotensis (Keyserling) is synonymized with Tropicosa thorelli (Keyserling) comb. nov., and Lycosa langei Mello-Leitão with T. chelifasciata (Mello-Leitão) comb. nov. based on examined types. All the four species proposed as members of Tropicosa gen. nov. have South American distribution.

Tidying things up: Tropicosa, a new Neotropical wolf spider genus (Araneae: Lycosidae: Lycosinae)

The new genus Tropicosa is proposed based on species of some controversial Neotropical genera of lycosids. These spiders present a longitudinal dark stripe over the sternum in both sexes, median apophysis sinuous, tegular lobe evidently sclerotized and the epigyne with median septum anteriorly expanded and with a parallel, triangular hood. We transfer Alopecosa moesta (Holmberg), Schizocosa chelifasciata (Mello-Leitão) and Lycosa thorelli (Keyserling) to Tropicosa gen. nov. and describe one new species, Tropicosa baguala sp. nov. Likewise, Arctosa bogotensis (Keyserling) is synonymized with Tropicosa thorelli (Keyserling) comb. nov., and Lycosa langei Mello-Leitão with T. chelifasciata (Mello-Leitão) comb. nov. based on examined types. All the four species proposed as members of Tropicosa gen. nov. have South American distribution.

Premature mortality due to noncommunicable diseases in Brazilian capitals: redistribution of garbage causes and evolution by social deprivation strata / Mortalidade prematura por doenças crônicas não transmissíveis em capitais brasileiras: redistribuição de causas garbage e evolução por estratos de privação social

ABSTRACT Objective: To analyze premature mortality due to noncommunicable chronic diseases (NCDs) in Brazilian capitals and the Federal District (DF) after redistribution of garbage causes and the temporal evolution according to social deprivation strata in the 2010 to 2012 and 2017 to 2019 triennia. Methods: Corrections were applied to the Mortality Information System (Sistema de Informação sobre Mortalidade - SIM) data such as the redistribution of garbage codes (GC). Premature mortality rates due to NCDs were calculated and standardized by age. The differences among NCDs mortality rates were analyzed according to the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP) categories and between the three-year periods. Results: In the capitals as a whole, rates increased between 8 and 12% after GC redistribution and the greatest increases occurred in areas of high deprivation: 11.9 and 11.4%, triennia 1 and 2, respectively. There was variability between the capitals. There was a reduction in rates in all strata of deprivation between the three-year periods, with the greatest decrease in the stratum of low deprivation (-18.2%) and the lowest in the stratum of high deprivation (-7.5%). Conclusion: The redistribution of GC represented an increase in mortality rates, being higher in the strata of greater social deprivation. As a rule, a positive gradient of mortality was observed with increasing social deprivation. The analysis of the temporal evolution showed a decrease in mortality from NCDs between the triennia, especially in areas of lower social deprivation.

RESUMO Objetivo: Analisar a mortalidade prematura por doenças crônicas não transmissíveis (DCNT) nas capitais brasileiras e Distrito Federal (DF) após redistribuição das causas garbage, e a evolução temporal segundo estratos de privação social nos triênios 2010 a 2012 e 2017 a 2019. Métodos: Foram aplicadas correções ao Sistema de Informação sobre Mortalidade (SIM), sendo empregada metodologia para redistribuição das causas garbage (CG). As taxas de mortalidade prematura por DCNT padronizadas por idade foram estimadas. Foram analisadas as diferenças entre as taxas de mortalidade por DCNT segundo categorias do Índice Brasileiro de Privação (IBP) e entre os triênios. Resultados: No conjunto das capitais, as taxas aumentaram entre 8 e 12% após a redistribuição de CG, e os maiores acréscimos ocorreram em áreas de alta privação: 11,9 e 11,4%, triênios 1 e 2, respectivamente. Houve variabilidade entre as capitais. Observou-se redução das taxas em todos os estratos de privação entre os triênios, sendo maior decréscimo no estrato de baixa privação (-18,2%), e menor no estrato de alta privação (-7,5%). Conclusão: A redistribuição de CG representou aumento das taxas de mortalidade, sendo maior nos estratos de maior privação social. Via de regra, observou-se gradiente positivo de mortalidade com o aumento da privação social. A análise da evolução temporal evidenciou decréscimo da mortalidade por DCNT entre os triênios, sobretudo em áreas de menor privação social.

Prevalence of adult smokers in Brazilian capitals according to socioeconomic deprivation / Prevalência de fumantes adultos nas capitais brasileiras, segundo privação socioeconômica

ABSTRACT Objective: To estimate the prevalence of adult smokers in the 26 capitals and the Federal District according to the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). Methods: Dataset on smoking were obtained from the Surveillance of Risk and Protective Factors for Noncommunicable Diseases by Survey (Vigitel) system for the 26 capitals and the Federal District, in the period from 2010 to 2013. The IBP classifies the census sectors according to indicators such as: income less than ½ minimum wage, illiterate population and without sanitary sewage. In the North and Northeast regions, the census sectors were grouped into four categories (low, medium, high and very high deprivation) and in the South, Southeast and Midwest regions into three (low, medium and high deprivation). Prevalence estimates of adult smokers were obtained using the indirect estimation method in small areas. To calculate the prevalence ratios, Poisson models are used. Results: The positive association between prevalence and deprivation of census sector categories was found in 16 (59.3%) of the 27 cities. In nine (33.3%) cities, the sectors with the greatest deprivation had a higher prevalence of smokers when compared to those with the least deprivation, and in two (7.4%) there were no differences. In Aracaju, Belém, Fortaleza, João Pessoa, Macapá and Salvador, the prevalence of adult smokers was three times higher in the group of sectors with greater deprivation compared to those with less deprivation. Conclusion: Sectors with greater social deprivation had a higher prevalence of smoking, compared with less deprivation, pointing to social inequalities.

RESUMO Objetivo: Estimar as prevalências de adultos fumante nas 26 capitais e no Distrito Federal segundo o Índice Brasileiro de Privação. Métodos: Os dados sobre tabagismo foram obtidos junto ao sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito (Vigitel) para as 26 capitais e o Distrito Federal, no período de 2010 a 2013. O Índice Brasileiro de Privação classifica os setores censitários segundo indicadores como: renda menor que meio salário mínimo, população não alfabetizada e sem esgotamento sanitário. Nas regiões Norte e Nordeste, os setores censitários foram agrupados em quatro categorias (baixa, média, alta e muito alta privação) e, nas regiões Sul, Sudeste e Centro-Oeste, em três (baixa, média e alta privação). As estimativas de prevalências de adultos fumantes foram obtidas pelo método indireto de estimação em pequenas áreas. Para o cálculo das razões de prevalências, empregram-se modelos de Poisson. Resultados: A associação positiva entre a prevalência e a privação das categorias de setores censitários foi encontrada em 16 (59,3%) das 27 cidades. Em nove (33,3%) cidades, os setores de maior privação apresentaram maior prevalência de fumantes quando comparados aos de menor privação e, em duas (7,4%), não apresentaram diferenças. Em Aracaju, Belém, Fortaleza, João Pessoa, Macapá e Salvador, as prevalências de adultos fumantes foram três vezes maiores no grupo de setores com maior privação em relação aos de menor privação. Conclusão: Setores de maior privação social apresentaram maiores prevalências de tabagismo, comparados com menor privação, apontando desigualdades sociais.

Premature mortality due to noncommunicable diseases in Brazilian capitals: redistribution of garbage causes and evolution by social deprivation strata / Mortalidade prematura por doenças crônicas não transmissíveis em capitais brasileiras: redistribuição de causas garbage e evolução por estratos de privação social

Objectives: To analyze premature mortality due to noncommunicable diseases (NCDs) in Brazilian capitals and the Federal District (DF) according to the redistribution of garbage causes and the temporal evolution according to social deprivation strata in the trienniums 2010 to 2012 and 2017 to 2019. Methods: Corrections were applied to the Mortality Information System (SIM) such as: proportional redistribution of ignored and blank data and garbage causes (GC). Municipal premature mortality rates from NCDs were calculated using the local empirical Bayesian estimator and standardized by age. Differences between NCD mortality rates according to the Brazilian Deprivation Index (IBP) categories and between the three-year periods were analyzed. Results: In the capitals as a whole, rates increased between 8 and 12% after the GC redistribution and the greatest increases occurred in areas of high deprivation: 11.9% and 11.4%, triennia 1 and 2. There was variability between the capitals. There was a reduction in rates in all strata of deprivation between the three-year periods, with the greatest decrease in the stratum of low deprivation (-18.2%) and the lowest in the stratum of high deprivation (-7.5%). Conclusion: The redistribution of GC represented an increase in mortality rates, being higher in the strata of greater social deprivation. As a rule, a positive gradient of mortality was observed with increasing social deprivation. The analysis of the temporal evolution showed a decrease in mortality from NCDs between the three years, especially in areas of less social deprivation.

Objetivos: Analisar a mortalidade prematura por doenças crônicas não transmissíveis (DCNT) nas capitais brasileiras e Distrito Federal (DF) segundo redistribuição das causas garbage e a evolução temporal segundo estratos de privação social nos triênios 2010 a 2012 e 2017 a 2019. Métodos: Foram aplicadas correções ao Sistema de Informação sobre Mortalidade (SIM) como: redistribuição proporcional de dados ignorados e em branco, e das causas garbage (CG). As taxas municipais de mortalidade prematura por DCNT foram calculadas pelo estimador bayesiano empírico local e padronizadas por idade. Foram analisadas diferenças entre as taxas de mortalidade por DCNT segundo categorias do Índice Brasileiro de Privação (IBP) e entre os triênios. Resultados: No conjunto das capitais, as taxas aumentaram entre 8 a 12% após a redistribuição de CG e os maiores acréscimos ocorreram em áreas de alta privação: 11,9% e 11,4%, triênios 1 e 2. Houve variabilidade entre as capitais. Observou-se redução das taxas em todos os estratos de privação entre os triênios, sendo maior decréscimo no estrato de baixa privação (-18,2%) e menor no estrato de alta privação (-7,5%). Conclusão: A redistribuição de CG representou aumento das taxas de mortalidade, sendo maior nos estratos de maior privação social. Via de regra, observou-se gradiente positivo de mortalidade com o aumento da privação social. A análise da evolução temporal evidenciou decréscimo da mortalidade por DCNT entre os triênios, sobretudo em áreas de menor privação social.

Effectiveness of Telemedicine in Reducing Hospitalizations in Patients Discharged from the Hospital Due to Heart Failure: A Randomized Clinical Trial Protocol

Abstract Fundament: Telemedicine for follow-up in heart failure (HF) patients is effective in reducing hospitalizations, total and cardiovascular mortality. However, few studies were conducted in low and middle income, where lower access to technology and illiteracy could impact the results. Objective: To assess the effectiveness of associating telemedicine strategies, when compared to usual care, in reducing hospitalizations related to HF in patients discharged from the hospital due to HF. Methods: Controlled, randomized, multicenter, parallel-arm clinical trial, with an allocation ratio of 1:1, blinded to outcome evaluation, in which 340 patients who were discharged from public hospitals in Belo Horizonte due to HF will be randomized. Patients will be followed for 6 months and the intervention group will receive, in addition to the usual care, Structured Telephone Support (STS) from a nurse, a doctor, and an educational program. Counseling will be according to a clinical decision tree. The level of significance in the statistical analysis will be 5%. Expected results: Reduction in the number of hospital readmissions and/or in hospitalization time, in addition to developing a software with a clinical decision tree for remote follow-up and patient education about HF adapted to local culture. Conclusions: The intention of this study is to develop a telemedicine strategy and assess whether or not, in addition to the usual care, it is effective in reducing hospitalizations and mortality from HF. If effective, the aforementioned strategy could reduce costs and hospital needs in the Unified Health System (SUS, in Portuguese) for patients with HF. These results will be even more relevant considering the pandemic of COVID-19.

Sintomas urinários e a qualidade de vida de mulheres no pós-tratamento de câncer do colo do útero / Urinary symptoms and quality of life of women after cervical cancer treatment

Introdução: O tratamento para o câncer de colo do útero (CCU) traz sequelas para o trato urinário inferior que podem resultar em sintomas urinários. Objetivo: Analisar as queixas urinárias e a qualidade de vida (QV) de mulheres no pós-tratamento de CCU. Métodos: Estudo transversal, com amostragem por conveniencia, realizado com 44 mulheres encaminhadas por médicos oncologistas. Utilizou-se uma ficha de avaliação fisioterapêutica, o questionário "King's Health Questionnaire" (KHQ) para avaliar a QV. A apresentação da estatística descritiva foi feita com as frequências das variáveis e suas respectivas porcentagens. Para a apresentação dos dados do KHQ, utilizaram-se as frequências, porcentagens e intervalo de confiança de 95%. Resultados: As queixas urinárias relatadas foram urgência miccional, incontinência urinária de esforço (IUE) e noctúria, 23%, 20%, 20%, respectivamente. Os grupos que realizaram tratamento adjuvante apresentaram mais queixas urinárias quando comparados com as participantes que realizaram somente a cirurgia. A QV esteve alterada para pior em sete dos oito domínios do KHQ. Conclusão: O tratamento para CCU pode gerar diversos sintomas urinários para estas mulheres, sendo estes efeitos negativos de curto e longo prazo. A urgência miccional teve maior prevalencia e percebeu-se piores resultados quando realizado o tratamento adjuvante.