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Studies from more than 10 years ago showed epinephrine treatment of food-induced anaphylaxis in the emergency department (ED) was unacceptably low. We investigated whether epinephrine treatment of food-induced and other cause anaphylaxis in United States and Canadian EDs has changed over time. Guided by a health sciences librarian, we performed a systematic search in Medline, Embase, and Web of Science on 11 January 2023. We included observational studies that reported epinephrine use to treat anaphylaxis in the ED. We stratified by anaphylaxis etiology (food-, venom-, medication-induced, or any cause). Associations between year and epinephrine use were tested using Spearman correlation and proportional meta-analysis. Of 2458 records identified in our initial search, 40 met inclusion criteria. Of these, 14 examined food-induced, 4 venom-induced, 0 medication-induced, and 24 any cause anaphylaxis. For epinephrine treatment of food-induced anaphylaxis in the ED, among studies using similar definition of anaphylaxis, meta-analysis showed a pooled value of 20.7% (95% CI 17.8, 23.8) for studies performed >10 years ago and 45.1% (95% CI 38.4, 52.0) from those in the last 10 years. For anaphylaxis of any cause, there was no change over time, with a pooled value of 45.0% (95% CI 39.8, 50.3) over the last 10 years. Epinephrine treatment of food-induced anaphylaxis in the ED has increased over time. There was no clear change for anaphylaxis of any cause. Over the last 10 years, approximately 45% of ED patients with anaphylaxis received epinephrine. A limitation of the evidence is heterogeneity in anaphylaxis definitions.

Objective Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity. Methods ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement. Results This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native

Limited studies examine how prenatal environmental and social exposures jointly impact perinatal health. Here we investigated relationships between a neighborhood-level combined exposure (CE) index assessed during pregnancy and perinatal outcomes, including birthweight, gestational age, and preterm birth. Across all participants, higher CE index scores were associated with small decreases in birthweight and gestational age. We also observed effect modification by race; infants born to Black pregnant people had a greater risk of preterm birth for higher CE values compared to White infants. Overall, our results suggest that neighborhood social and environmental exposures have a small but measurable joint effect on neonatal indicators of health.

RationaleAsthma and obesity often co-occur. It has been hypothesized that asthma may contribute to childhood obesity onset.ObjectivesTo determine if childhood asthma is associated with incident obesity and examine the role of asthma medication in this association.MethodsWe studied 8,716 children between ages 6 and 18.5 years who were nonobese at study entry participating in 18 US cohorts of the Environmental influences on Child Health Outcomes program (among 7,299 children with complete covariate data mean [SD] study entry age = 7.2 [1.6] years and follow up = 5.3 [3.1] years).Measurements and main resultsWe defined asthma based on caregiver report of provider diagnosis. Incident obesity was defined as the first documented body mass index ≥95th percentile for age and sex following asthma status ascertainment. Over the study period, 26% of children had an asthma diagnosis and 11% developed obesity. Cox proportional hazards models with sex-specific baseline hazards were fitted to assess the association of asthma diagnosis with obesity incidence. Children with asthma had a 23% (95% confidence intervals [CI] = 4, 44) higher risk for subsequently developing obesity compared with those without asthma. A novel mediation analysis was also conducted to decompose the total asthma effect on obesity into pathways mediated and not mediated by asthma medication use. Use of asthma medication attenuated the total estimated effect of asthma on obesity by 64% (excess hazard ratios = 0.64; 95% CI = -1.05, -0.23).ConclusionsThis nationwide study supports the hypothesis that childhood asthma is associated with later risk of obesity. Asthma medication may reduce this association and merits further investigation as a potential strategy for obesity prevention among children with asthma.

Supplementary file for manuscript entitled, "Prediction of vitamin D deficiency in older adults: the role of machine learning models"

Additional file 1: Supplemental Figure 1. Health-related social needs institutional screening questionnaire. Supplemental Table 1. Characteristics of Medicaid Accountable Care Organization (ACO) patients who completed health-related social needs (HRSN) screening in the payor subset. Supplemental Table 2. Social risk factors (positive screening response) and social needs (request for more information) among health-related social needs (HRSN) questionnaires completed in the payor subset. Supplemental Table 3. Patient and practice characteristics associated with expressing social need, with and without social risk factors on health-related social need (HRSN) screening in the payor subset. Supplemental Table 4. Patient and practice characteristics associated with expressing social need in domains concordant and discordant with social risk factors on health-related social needs (HRSN) screening in the payor subset.

[This corrects the article DOI: 10.1371/journal.pone.0245064.].

Supplementary file for manuscript entitled, "Prediction of vitamin D deficiency in older adults: the role of machine learning models"

To investigate associations between obstructive sleep apnea (OSA) and readmission risk after hospitalization for asthma exacerbation. We conducted a retrospective, population-based cohort study using State Inpatient Databases from seven U.S. states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 to 2013. We identified all adults (aged 18–54 years) hospitalized for asthma exacerbation. The outcome measure was all-cause readmissions within one year after hospitalization for asthma exacerbation. To determine associations between OSA and readmission risk, we constructed negative binomial regression models estimating the incidence rate ratio (IRR) for readmissions and Cox proportional hazards models estimating hazard rate (HR) for the time-to-first readmission. Among 65,731 patients hospitalized for asthma exacerbation, 6,549 (10.0%) had OSA. Overall, OSA was associated with significantly higher incident rate of all cause readmission (1.36 vs. 0.85 readmissions per person-year; unadjusted IRR 1.60; 95%CI 1.54–1.66). Additionally, OSA was associated with higher incident rates of readmissions for five major diseases—asthma (IRR 1.21; 95%CI 1.15–1.27), COPD (IRR 2.03; 95%CI 1.88–2.19), respiratory failure (IRR 3.04; 95%CI 2.76–3.34), pneumonia (IRR 1.67; 95%CI 1.49–1.88), and congestive heart failure (IRR 3.78; 95%CI 3.36–4.24), compared to non-OSA. The Cox model demonstrated that patients with OSA had significantly higher rates for all-cause readmission compared to those without OSA (HR 1.56; 95% CI 1.50–1.62). These associations remained significant after adjustment for confounders. The observed association of OSA with a higher risk of readmissions after hospitalization for asthma exacerbation underscores the importance of identifying coexistent OSA in this population and optimizing both OSA and asthma management.

Additional file 2: Table S2. Definition of the 14 pre-specified obstetric conditions and events.

Additional file 3: Table S3. Scoring for the modified early obstetric warning system (MEOWS).

Additional file 1: Table S1. Identification of EMS 911 activations for a potential obstetric event in patients of childbearing age (12-50 years).

La demanda de los equipos eléctricos y electrónicos que ha generado el adelanto tecnológico presenta un inconveniente, irradiar de forma intencional o no cantidades variables de energía electromagnética alrededor de su espacio circundante. Lo que conlleva a que la interacción de estos equipos produzca interferencia electromagnética, cuyas consecuencias son: mal funcionamiento, perturbaciones en las comunicaciones y riesgo para la salud. La verdadera razón es para utilizarlos en recintos cerrados para ensayos de compatibilidad electromagnética, como sustituto a los importados, lo que implica una previa evaluación de sus propiedades y un diseño que considere su forma, estructura, coeficiente de reflexión y atenuación. En este trabajo se tratará de construir absorbedores de señal que trabajará con un rango de 30 MHz a 5 GHz del espectro radioeléctrico a través de un material absorbente de prueba de ondas electromagnéticas que consta de carbón mineral , madera (cañaguate) (Tecoma spectabilis) ,cactus(Stenocereus griseus) y poliuretano de geometría planar. Las ecuaciones pueden ser resueltas explícitamente para algunos casos y configuraciones particulares (por ejemplo, incidencia normal). El absorbedor se construyó por capas con un espesor homogéneo para cada mezcla, entre el poliuretano con cactus, cañaguate, y carbón mineral, luego se evaluó su coeficiente de atenuación en el laboratorio de comunicaciones de la facultad de ingeniería de la universidad del Zulia. Los resultados obtenidos fueron óptimos, dado que cada capa fue evaluada con la mayor rigurosidad posible lo cual indica que se pueden construir absorbedores de ondas electromagnéticas con material del medio a bajo costo recomendando su uso.

Online Data Supplemental Text. (DOCX 129 kb)

Figure S1. QQ plot of resting heart rate. Figure S2. QQ plot of high blood pressure. Figure S3. Genetic Correlation between COPD and Cardiac Traits by Functional Category. (PDF 360 kb)

Comparison of predictor variables and outcomes between the analytic and non-analytic cohort. (DOCX 16 kb)

Importance: Previous randomized controlled trials have provided inconsistent results on the effect of vitamin D supplementation on cancer incidence. Objective: To determine if monthly high-dose vitamin D supplementation, without calcium, reduces cancer incidence and cancer mortality in the general population. Design: Randomized, double-blind, placebo-controlled trial, participants recruited from April 2011 to November 2012, follow-up until December 2015. Setting: Recruited mostly from family practices in Auckland, New Zealand. Participants: Community-resident adults, aged 50-84 years. Out of 47,905 adults invited from family practices, and 163 from community groups, 5,110 participants were randomized to vitamin D3 (n=2,558) or placebo (n=2,552). Two participants withdrew consent, and all others (n=5,108) were included in the primary analysis. Intervention: Oral vitamin D3, initial bolus dose of 200,000 IU, followed one month later by monthly doses of 100,000 IU, or placebo, for median of 3.3 years (range: 2.5–4.2 years). Main Outcomes and Measures: The post-hoc primary outcome was all primary neoplasms (invasive and in-situ), aside from non-melanoma skin cancers, diagnosed from randomization to stopping the study medication (31 July 2015). Secondary outcomes were all neoplasms: from randomization to 31 December 2015; from >12 months after randomization to both stopping the study medication and also to 31 December 2015; and fatal neoplasms from randomization to 31 December 2015., Major funding was provided by the Health Research Council of New Zealand (grant 10/400), and by the Accident Compensation Corporation of New Zealand.

Supplemental material, Supplemental Material2 for A national survey of telemedicine use by US emergency departments by Kori S Zachrison, Krislyn M Boggs, Emily M Hayden, Janice A Espinola and Carlos A Camargo in Journal of Telemedicine and Telecare

Organ system, infectious disease diagnostic groups and associated ICD-10 codes [2, 34]. (DOCX 30 kb)

Acute lower respiratory infection syndromes and associated ICD-10 codes [2, 34]. (DOCX 24 kb)

Associations of demographic and illness characteristics with risk of hospital readmission with a second skin and soft tissue infection within 12Â months of a first hospital admission with a skin and soft tissue infection. (DOCX 91 kb)

Associations of demographic and illness characteristics with risk of hospital readmission with a second acute respiratory infection within 12Â months of a first hospital admission with an acute respiratory infection. (DOCX 90 kb)

Supplemental material, Supplemental Material1 for A national survey of telemedicine use by US emergency departments by Kori S Zachrison, Krislyn M Boggs, Emily M Hayden, Janice A Espinola and Carlos A Camargo in Journal of Telemedicine and Telecare

Additional file 1. Health questionnaire.

Associations of demographic and illness characteristics with risk of hospital readmission with a second enteric infection within 12Â months of a first hospital admission with an enteric infection. (DOCX 86 kb)

Supplemental material, Supplemental Method and Tables for Age-related differences in the rate and diagnosis of 30-day readmission after hospitalization for acute ischemic stroke by Atsushi Hirayama, Tadahiro Goto, Mohammad K Faridi, Carlos A Camargo Jr and Kohei Hasegawa in International Journal of Stroke

ObjectiveTo estimate the global and national burden of emergency conditions, and compare them to emergency care usage rates.MethodsWe coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care usage rates were obtained from a systematic literature review on emergency care facilities in low-income and middle-income countries (LMICs), supplemented by national health system reports.FindingsAll 15 leading causes of death and disability-adjusted life years (DALYs) globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency usage. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47 728 per 100 000 population (IQR 45 253-50 085) in low-income, 25 186 (IQR 21 982-40 480) in middle-income and 15 691 (IQR 14 649-16 382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency usage rates were the lowest in low-income countries, with median 8 visits per 1000 population (IQR 6-10), 78 (IQR 25-197) in middle-income and 264 (IQR 177-341) in high-income countries.ConclusionsDespite higher burden of emergency conditions, emergency usage rates are substantially lower in LMICs, likely due to limited access to emergency care.

BackgroundLittle is known about the longitudinal change in the quality of acute asthma care for hospitalized children and adults in the United States. We investigated whether the concordance of inpatient asthma care with the national guidelines improved over time, identified hospital characteristics predictive of guideline concordance, and determined whether guideline-concordant care is associated with a shorter hospital length of stay (LOS).MethodsThis study was an analysis of data from two multicenter chart review studies of hospitalized patients aged 2 to 54 years with acute asthma during two time periods: 1999-2000 and 2012-2013. Outcomes were guideline concordance at the patient and hospital levels, and association of patient composite concordance with hospital LOS.ResultsThe analytic cohort for the comparison of guideline concordance comprised 1,634 patients: 834 patients from 1999-2000 vs800 patients from 2012-2013. Over these 15 years, inpatient asthma care became more concordant at the hospital-level, with the mean composite score increasing from 74 to 82 (P< .001). However, during 2012-2013, wide variability in guideline concordance of acute asthma care remained across hospitals, with the greatest variation in provision of individualized written action plan at discharge (SD, 36). Guideline concordance was significantly lower in Midwestern and Southern hospitals compared with Northeastern hospitals. After adjusting for severity, patients who received care perfectly concordant with the guidelines had significantly shorter hospital LOS (-14%[95%CI, -23 to -4]; P= .009).ConclusionsBetween 1999 and 2013, the guideline concordance of acute asthma care for hospitalized patients improved. However, interhospital variability remains substantial. Greater concordance with evidence-based guidelines was associated with a shorter hospital LOS.

Consent Form-Storage of Blood Sample. (DOC 244 kb)

SPIRIT Checklist. (DOCX 50 kb)

International Classification of Diseases, Ninth Revision, Clinical Modification codes for major causes of sepsis. Table S2. Patient and hospital characteristics in the subgroup with vasopressor use, 2005-2011. Table S3. Patient and hospital characteristics in the subgroup without vasopressor use, 2005-2011. Table S4. Unadjusted mortality among patients hospitalized for septic shock in the US, 2005-2011. Table S5. Odds ratio of inhospital mortality in patients hospitalized for septic shock in the US, 2005-2011.

Information Sheet. (PDF 319 kb)

Consent Form-Main. (DOC 242 kb)

International Classification of Diseases, Ninth Revision, Clinical Modification codes for major causes of sepsis. Table S2. Patient and hospital characteristics in the subgroup with vasopressor use, 2005-2011. Table S3. Patient and hospital characteristics in the subgroup without vasopressor use, 2005-2011. Table S4. Unadjusted mortality among patients hospitalized for septic shock in the US, 2005-2011. Table S5. Odds ratio of inhospital mortality in patients hospitalized for septic shock in the US, 2005-2011.

Survey instrument, in English and Spanish. The NEDI instrument includes four major branch points leading to 10 different surveys with content tailored to the specific type of ED. The major branch points are as follows: (1) contiguous vs non-contiguous, (2) triage to service vs no triage to service, (3) open 24/7 vs not open 24/7, and (4) one leader vs >1 leader. The compiled data from the surveys were subsequently combined into one dataset and recorded in Microsoft Excel. Included is a sample survey for a contiguous ED with triage to service, 24/7, and one leader. (PDF 219 kb)

Background: Safety planning is a brief intervention that has become an accepted practice in many clinical settings to help prevent suicide. Even though it is quick compared to other approaches, it frequently requires 20 min or more to complete, which can impede adoption. A self-administered, Web-based safety planning application could potentially reduce clinician time, help promote standardization and quality, and provide enhanced ability to share the created plan. Objective: The aim of this study was to design, build, and test the usability of a Web-based, self-administered safety planning application. Methods: We employed a user-centered software design strategy led by a multidisciplinary team. The application was tested for usability with a target sample of suicidal patients. Detailed observations, structured usability ratings, and Think Aloud procedures were used. Suicidal ideation intensity and perceived ability to cope were assessed pre-post engagement with the Web application. Results: A total of 30 participants were enrolled. Usability ratings were generally strong, and all patients successfully built a safety plan. However, the completeness of the safety plan varied. The mean number of steps completed was 5.5 (SD 0.9) out of 6, with 90% (27/30) of participants completing at least 5 steps and 67% (20/30) completing all 6 steps. Some safety planning steps were viewed as inapplicable to some individuals. Some confusion in instructions led to modifications to improve understandability of each step. Ratings of suicide intensity after completion of the application were significantly lower than preratings, pre: mean 5.11 (SD 2.9) versus post: mean 4.46 (SD 3.0), t27=2.49, P=.02. Ratings of ability to cope with suicidal thoughts after completion of the application were higher than preratings, with the difference approaching statistical significance, pre: mean 5.93 (SD 2.9), post: mean 6.64 (SD 2.4), t27=−2.03, P=.05. Conclusions: We have taken the first step toward identifying the components needed to maximize usability of a self-administered, Web-based safety planning application. Results support initial consideration of the application as an adjunct to clinical contact. This allows for the clinician or other personnel to provide clarification, when needed, to help the patient build the plan, and to help review and revise the draft.

BackgroundDespite the substantial burden of asthma-related emergency department (ED) visits, there have been no recent multicenter efforts to characterize this high-risk population.ObjectiveWe aimed to characterize patients with asthma according to their frequency of ED visits and to identify factors associated with frequent ED visits.MethodsA multicenter chart review study of 48 EDs across 23 US states. We identified ED patients ages 18 to 54 years with acute asthma during 2011 and 2012. Primary outcome was frequency of ED visits for acute asthma in the past year, excluding the index ED visit.ResultsOf the 1890 enrolled patients, 863 patients (46%) had 1 or more (frequent) ED visits in the past year. Specifically, 28% had 1 to 2 visits, 11% had 3 to 5 visits, and 7% had 6 or more visits. Among frequent ED users, guideline-recommended management was suboptimal. For example, of patients with 6 or more ED visits, 85% lacked evidence of prior evaluation by an asthma specialist, and 43% were not treated with inhaled corticosteroids. In a multivariable model, significant predictors of frequent ED visits were public insurance, no insurance, and markers for chronic asthma severity (all P < .05). Stronger associations were found among those with a higher frequency of asthma-related ED visits (eg, 6 or more ED visits).ConclusionThis multicenter study of US adults with acute asthma demonstrated many frequent ED users and suboptimal preventive management in this high-risk population. Future reductions in asthma morbidity and associated health care utilization will require continued efforts to bridge these major gaps in asthma care.

Despite its relatively common occurrence and life-threatening potential, the management of angioedema in the emergency department (ED) is lacking in terms of a structured approach. It is paramount to distinguish the different etiologies of angioedema from one another and more specifically differentiate histaminergic-mediated angioedema from bradykinin-mediated angioedema, especially in lieu of the more novel treatments that have recently become available for bradykinin-mediated angioedema. With this background in mind, this consensus parameter for the evaluation and management of angioedema attempts to provide a working framework for emergency physicians (EPs) in approaching the patient with angioedema in terms of diagnosis and management in the ED. This consensus parameter was developed from a collaborative effort among a group of EPs and leading allergists with expertise in angioedema. After rigorous debate, review of the literature, and expert opinion, the following consensus guideline document was created. The document has been endorsed by the American College of Allergy, Asthma & Immunology (ACAAI) and the Society for Academic Emergency Medicine (SAEM).

Redmetrics es un proyecto de Software Libre cuya finalidad es la creación de una aplicación de gestión y control que facilite la planificación y seguimiento de proyectos de desarrollo de software. Redmetrics és un projecte de Programari Lliure que té com a finalitat la creació d'una aplicació de gestió i control que faciliti la planificació i seguiment de projectes de desenvolupament de programari. Redmetrics is an Open Source Software project aimed at creating a management and control application to facilitate planning and tracking of software development projects.

Available D-dimer assays have low specificity and may increase radiographic testing for pulmonary embolism (PE). To help clinicians better target testing, this study sought to quantify the effect of risk factors for a positive quantitative D-dimer in patients evaluated for PE.This was a prospective, multicenter, observational study. Emergency department (ED) patients evaluated for PE with a quantitative D-dimer were eligible for inclusion. The main outcome of interest was a positive D-dimer. Odds ratio (ORs) and 95% confidence intervals (CIs) were determined by multivariable logistic regression. Adjusted estimates of relative risk were also calculated.A total of 4,346 patients had D-dimer testing, of whom 2,930 (67%) were women. A total of 2,500 (57%) were white, 1,474 (34%) were black or African American, 238 (6%) were Hispanic, and 144 (3%) were of other race or ethnicity. The mean (+/-SD) age was 48 (+/-17) years. Overall, 1,903 (44%) D-dimers were positive. Model fit was adequate (c-statistic = 0.739, Hosmer and Lemeshow p-value = 0.13). Significant positive predictors of D-dimer positive included female sex; increasing age; black (vs. white) race; cocaine use; general, limb, or neurologic immobility; hemoptysis; hemodialysis; active malignancy; rheumatoid arthritis; lupus; sickle cell disease; prior venous thromboembolism (VTE; not under treatment); pregnancy and postpartum state; and abdominal, chest, orthopedic, or other surgery. Warfarin use was protective. In contrast, several variables known to be associated with PE were not associated with positive D-dimer results: body mass index (BMI), estrogen use, family history of PE, (inactive) malignancy, thrombophilia, trauma within 4 weeks, travel, and prior VTE (under treatment).Many factors are associated with a positive D-dimer test. The effect of these factors on the usefulness of the test should be considered prior to ordering a D-dimer.

Orientador: Hélio Afonso G. Teive Co-orientadora: Rosana H. Scola Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Medicina Interna. Defesa: Curitiba, 01 de dezembro de 2007. Inclui bibliografia Área de concentração: Medicina interna

Pesquisas relacionadas ao ambiente citadino mostram a expansão urbana associada ao planejamento ineficaz como o motivo de degradação do ambiente, com interferências na qualidade de vida. Para suportar o aumento da demanda populacional, é necessária a realização de um planejamento urbano que considere os indicadores de qualidade de vida. A metodologia desta pesquisa engloba a aglutinação de dados (atributos) cartografáveis da cidade de Presidente Prudente/SP para posterior cruzamento e elaboração da Carta de Qualidade Ambiental. Densidade Populacional, Uso e Ocupação do Solo, dentre os outros atributos, são importantes no estudo da qualidade ambiental, pois interferem diretamente nas características físicas e ambientais da cidade. Resultados preliminares mostram que a cidade de Presidente Prudente/SP possui grande concentração de pessoas, que, devido a questões financeiras, se instalaram em ambientes deteriorados e de péssima qualidade ambiental, locais pobres, de baixo custo de vida e sem infra-estrutura, comprometendo a saúde e o ambiente habitado., Researches related to the environment city dweller shows the associated urban expansion to the inefficacious planning as the reason of degradation of the environment, with interferences in the quality of life. To endure the increase of the population demand, it has the necessity of the accomplishment of an urban planning that considers the pointers of quality of life The methodology of this research encloses the union of data (attributes) that can be mapped of the Presidente Prudente/SP city for a later combination and elaboration of the Map of Ambient Quality. Population density, Use and Occupation of the Soil, amongst the others attributes, are important in the study of the ambient quality, therefore, they intervene directly in the physical and ambient characteristics of the city. Preliminary results show that the city of Presidente Prudente/SP possess large concentration of people, that, just because financial questions, settles down in spoiled places with a very bad environment quality, poor places, of low cost of living and no infrastructure, compromising the health and inhabited places.