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Decisões críticas no combate à pandemia causada pelo SARS-CoV-2 têm sido realizadas frequentemente com dados e informações ainda incompletas. Enquanto os órgãos pertinentes não solucionam os gargalos no fluxo de informações de vital importância, epidemiólogos e outros pesquisadores devem produzir subsídios técnicos para o enfrentamento da crise contornando essas limitações. No presente estudo, focado no Brasil, comparamos os óbitos pelo SARS-CoV-2, disponibilizados diariamente, com os dados de óbitos por doenças respiratórias e outras doenças nos anos de 2014 a 2018 (os últimos cinco anos completos para os quais os dados estão disponíveis). Adicionalmente, extraímos os sinais temporais anuais dos óbitos por doenças respiratórias para que o período típico de pico na mortalidade por essas doenças possa ser considerado em cada estado Brasileiro. A porcentagem de óbitos pelo SARS-CoV-2 até o dia 15 de abril equivale a 24% da mortalidade esperada por causas respiratórias no mesmo período, com base em anos anteriores, com grande variação entre os estados (desde o Amazonas, 151%, até o Tocantins, com 3%). Estamos na época típica de pico de mortalidade associada a doenças respiratórias em grande parte do Norte e Nordeste (com exceção de Roraima). Nas regiões Sudeste e Sul, esse pico é mais tardio (junho–agosto). A evolução da pandemia em cada estado dependerá, no entanto, de vários outros fatores, como o comportamento do patógeno – ainda não conhecido suficientemente. Ressaltamos a necessidade de ações para aumento da agilidade na disponibilização dos dados atuais de mortalidade (por diversas causas), para que equipes de pesquisa com diferentes abordagens analíticas possam se somar no combate a este desafio sanitário global.

Resumo OBJETIVO: apresentar um método para estimação dos indicadores de prevalência de baixo peso ao nascer (BPN) e coeficiente de mortalidade infantil (CMI) para municípios brasileiros, de modo a incorporar considerações de flutuação amostral. MÉTODOS: as distribuições binomial e de Poisson foram usadas para estimar os intervalos de confiança de 95% (IC95%); quando o número de óbitos infantis foi zero, o limite superior do IC95% foi estimado pelo método da "regra do três"; como demonstração, foram estimados indicadores para o ano de 2012. RESULTADOS: observou-se discreto aumento do BPN e diminuição do CMI com o aumento da população municipal; as estimativas foram mais precisas para o BPN do que para o CMI, apresentaram grande amplitude dos IC95% em municípios pequenos e baixa confiabilidade quando analisadas apenas para um ano específico. CONCLUSÃO: foi desenvolvida uma planilha eletrônica que permitirá aos gestores estimarem a precisão desses indicadores para seus municípios.

Pain experience involves a complex relationship between sensory and both emotional and cognitive factors, which appear to be mediated by different neural pathways. Previous evidence has shown that whereas conscious processing of unpleasant stimuli enhances pain perception, the influence of emotions on pain under unaware conditions is much less known. The need to better characterise the relationship between pain processing and emotional factors is crucial for dealing with chronic pain conditions. Therefore, the present study aimed to explore the neural correlates relating to the influence of visual masking emotional stimulation on the processing of painful stimuli in chronic pain patients suffering from fibromyalgia (FM). Twenty FM and 22 healthy control (HC) women participated in the study. The experimental masking paradigm consisted of a rapid succession of two types of stimuli, where a masked picture (neutral, negative or pain-related) was followed by a laser stimulus (painful or not painful). LEP activity was recorded at sixty scalp electrodes. An LEP-amplitude approach was used to quantify the main cerebral waves linked to pain response. ANOVAs indicated that the posterior regions of the P1 component were sensitive to experimental manipulation (p

to describe the prevalence coefficients and characterize cases of microcephaly at birth in Brazil from 2000-2015.this is a descriptive study with data from the Information System on Live Births (Sinasc). The coefficients were calculated by region and characteristics of mothers and live births (LB).the annual average number of microcephaly cases was 164 for the period 2000-2014, whilst in 2015, 1,608 cases were registered (54.6 cases per 100 thousand LB). Higher coefficients were observed among preterm babies (81.7; 95%CI 72.3;92.2), born from black-skinned (70.9; 95%CI 58.5;85.9) or to brown-skinned (71.5; 95%CI67.4;75.8) women, to women aged ≤19 (70.3; 95%CI 63.5;77.8) or ≥40 (62.1; 95%CI 46.6;82.6), with ≤3 years of study (73.4; 95%CI 58.2;92.4) and residents in the Northeast region (138.7; 95%CI 130.9;147.0).the high number of microcephaly cases in 2015 reinforces the importance of Sinasc and the need to improve the surveillance of congenital anomalies.

to present a method for estimating low birth weight (LBW) prevalence and infant mortality rate (IMR) indicators for Brazilian municipalities, so as to incorporate considerations with regard to sampling fluctuation.binomial and Poisson distributions were used to estimate 95% confidence intervals (95%CI); when the number of infant deaths was zero, the upper limit of the 95%CI was estimated by the cross-multiplication method; indicators were estimated for the year 2012 for demonstration purposes.a slight increase in LBW and a decrease in IMR were detected as municipality population size increased; LBW estimates were more accurate than those for IMR; single-year estimates showed large width 95%CI in small municipalities and low reliability.an electronic spreadsheet was developed which will allow service managers to estimate the precision of these indicators for their municipalities.

Although it is in the Tropics where nearly half of the world population lives and infectious disease burden is highest, little is known about the impact of influenza pandemics in this area. We investigated the mortality impact of the 2009 influenza pandemic relative to mortality rates from various outcomes in pre-pandemic years throughout a wide range of latitudes encompassing the entire tropical, and part of the subtropical, zone of the Southern Hemisphere (+5(°)N to -35(°)S) by focusing on a country with relatively uniform health care, disease surveillance, immunization and mitigation policies: Brazil. To this end, we analyzed laboratory-confirmed deaths and vital statistics mortality beyond pre-pandemic levels for each Brazilian state. Pneumonia, influenza and respiratory mortality were significantly higher during the pandemic, affecting predominantly adults aged 25 to 65 years. Overall, there were 2,273 and 2,787 additional P&I- and respiratory deaths during the pandemic, corresponding to a 5.2% and 2.7% increase, respectively, over average pre-pandemic annual mortality. However, there was a marked spatial structure in mortality that was independent of socio-demographic indicators and inversely related with income: mortality was progressively lower towards equatorial regions, where low or no difference from pre-pandemic mortality levels was identified. Additionally, the onset of pandemic-associated mortality was progressively delayed in equatorial states. Unexpectedly, there was no additional mortality from circulatory causes. Comparing disease burden reliably across regions is critical in those areas marked by competing health priorities and limited resources. Our results suggest, however, that tropical regions of the Southern Hemisphere may have been disproportionally less affected by the pandemic, and that climate may have played a key role in this regard. These findings have a direct bearing on global estimates of pandemic burden and the assessment of the role of immunological, socioeconomic and environmental drivers of the transmissibility and severity of this pandemic.