Abstract Objectives: to evaluate the contribution of the Maternal Mortality and Death Surveillance Committee for women of childbearing age (WCA) and maternal mortality in the magnitude of maternal mortality and in the qualification of the causes of death in Recife, Brazil. Methods: ex ante/ex post evaluation, ecological, of the annual indicators of mortality of WCA, maternal and case study of declared maternal deaths according to causes of death before and after surveillance. Deaths of WCA (2010 and 2017) were analyzed. The percentage of investigation of deaths of WCA was calculated; their rates and maternal mortality ratio (MMR) were estimated; the groups of causes of death, classification of death, the moment of death, the proportional variation before and after surveillance, and the relocation of the causes after this process were described. Results: 4.327 (97.0%) of deaths of WCA were investigated (increase of 40.7% of maternal deaths) and MMR of 62.9/100 thousand live births. Improved notifications of immediate/late (75.0%) and remote (300.0%) postpartum; there was a difference in direct obstetric causes, total maternal deaths and late maternal death (p<0.001). Conclusion: the surveillance and the Maternal Mortality Committee showed potential in identifying the magnitude and qualification of causes of maternal death in order to propose the interventions directed to obstetric care.

Resumo Objetivos: avaliar a contribuição do Comitê de Mortalidade Materna e da Vigilância do Óbito de mulheres em idade fértil (MIF) e materno na magnitude da mortalidade materna e na qualificação das causas dos óbitos no Recife, Brasil. Métodos: avaliação ex ante/ex post, ecológico, dos indicadores anuais de mortalidade de MIF, materna e estudo de caso de óbitos maternos declarados segundo causas de morte antes e após a vigilância. Analisaram-se óbitos de MIF (2010-2017) e calculou-se o percentual de investigação; estimaram-se suas taxas e a razão de mortalidade materna (RMM); descreveram-se: grupos de causa, classificação e momento do óbito, variação proporcional antes e após a vigilância/análise do comitê e a realocação das causas após esse processo. Resultados: investigou-se 4.327 (97,0%) dos óbitos de MIF (incremento de 40,7% das mortes maternas), e RMM de 62,9/100 mil nascidos vivos; melhoraram as notificações do puerpério imediato/ tardio (75,0%) e remoto (300,0%); houve diferença nas causas obstétricas diretas, total de óbitos maternos e morte materna tardia (p<0,001). Conclusão: mostrou-se o potencial da vigilância e do Comitê de Mortalidade Materna na identificação da magnitude e qualificação das causas de morte materna para proposição de medidas direcionadas aos cuidados obstétricos.

Objective: To analyse variations in the diagnostic confirmation process between screening units, variations in the outcome of each episode and the relationship between the use of the different diagnostic confirmation tests and the lesion detection rate. Method: Observational study of variability of the standardised use of diagnostic and lesion detection tests in 34 breast cancer mass screening units participating in early-detection programmes in three Spanish regions from 2002-2011. Results: The diagnostic test variation ratio in percentiles 25-75 ranged from 1.68 (further appointments) to 3.39 (fine-needle aspiration). The variation ratio in detection rates of benign lesions, ductal carcinoma in situ and invasive cancer were 2.79, 1.99 and 1.36, respectively. A positive relationship between rates of testing and detection rates was found with fine-needle aspiration-benign lesions (R²: 0.53), fine-needle aspiration-invasive carcinoma (R²: 0 28), core biopsy-benign lesions (R²: 0.64), core biopsy-ductal carcinoma in situ (R²: 0.61) and core biopsy-invasive carcinoma (R²: 0.48). Conclusions: Variation in the use of invasive tests between the breast cancer screening units participating in early-detection programmes was found to be significantly higher than variations in lesion detection. Units which conducted more fine-needle aspiration tests had higher benign lesion detection rates, while units that conducted more core biopsies detected more benign lesions and cancer.

Objetivo: Analizar las variaciones en el proceso de confirmación diagnóstica entre unidades de cribado, las variaciones en los resultados de cada episodio y la relación entre las tasas de las diferentes pruebas de confirmación diagnóstica y las de detección de lesiones. Método: Estudio observacional de las variaciones de las tasas estandarizadas de pruebas diagnósticas y de detección de lesiones, en 34 unidades de cribado de los programas poblacionales de detección precoz de cáncer de mama, de tres comunidades autónomas, en el periodo de 2002 a 2011. Resultados: Las razones de variación entre los percentiles 25-75 en las tasas de realización de pruebas diagnósticas oscilaron entre 1,68 (recitaciones) y 3,39 (punción-aspiración con aguja fina). En las tasas de detección de lesiones benignas, carcinoma ductal in situ y cáncer invasivo fueron, respectivamente, 2,79, 1,99 y 1,36. Se encontró una relación positiva entre las tasas de realización de pruebas y las tasas de detección en punción-aspiración con aguja fina y lesiones benignas (R²: 0,53), punción-aspiración con aguja fina y carcinoma invasivo (R²: 0, 28), biopsias cerradas y lesiones benignas (R²: 0,64), biopsias cerradas y carcinoma ductal in situ (R²: 0,61), y biopsias cerradas y carcinoma invasivo (R²: 0,48). Conclusiones: Se observaron variaciones en la realización de pruebas invasivas entre las unidades de detección precoz de cáncer de mama de mayor magnitud que las de detección de lesiones. Las unidades con más pruebas de punción-aspiración con aguja fina tienen mayores tasas de detección de lesiones benignas, y las que realizan más biopsias cerradas detectan más lesiones benignas y cáncer.

Objective: To analyse variations in the diagnostic confirmation process between screening units, variations in the outcome of each episode and the relationship between the use of the different diagnostic confirmation tests and the lesion detection rate. Method: Observational study of variability of the standardised use of diagnostic and lesion detection tests in 34 breast cancer mass screening units participating in early-detection programmes in three Spanish regions from 2002-2011. Results: The diagnostic test variation ratio in percentiles 25-75 ranged from 1.68 (further appointments) to 3.39 (fine-needle aspiration). The variation ratio in detection rates of benign lesions, ductal carcinoma in situ and invasive cancer were 2.79, 1.99 and 1.36, respectively. A positive relationship between rates of testing and detection rates was found with fine-needle aspiration-benign lesions (R²: 0.53), fine-needle aspiration-invasive carcinoma (R²: 0 28), core biopsy-benign lesions (R²: 0.64), core biopsy-ductal carcinoma in situ (R²: 0.61) and core biopsy-invasive carcinoma (R²: 0.48). Conclusions: Variation in the use of invasive tests between the breast cancer screening units participating in early-detection programmes was found to be significantly higher than variations in lesion detection. Units which conducted more fine-needle aspiration tests had higher benign lesion detection rates, while units that conducted more core biopsies detected more benign lesions and cancer.

Objetivo: Analizar las variaciones en el proceso de confirmación diagnóstica entre unidades de cribado, las variaciones en los resultados de cada episodio y la relación entre las tasas de las diferentes pruebas de confirmación diagnóstica y las de detección de lesiones. Método: Estudio observacional de las variaciones de las tasas estandarizadas de pruebas diagnósticas y de detección de lesiones, en 34 unidades de cribado de los programas poblacionales de detección precoz de cáncer de mama, de tres comunidades autónomas, en el periodo de 2002 a 2011. Resultados: Las razones de variación entre los percentiles 25-75 en las tasas de realización de pruebas diagnósticas oscilaron entre 1,68 (recitaciones) y 3,39 (punción-aspiración con aguja fina). En las tasas de detección de lesiones benignas, carcinoma ductal in situ y cáncer invasivo fueron, respectivamente, 2,79, 1,99 y 1,36. Se encontró una relación positiva entre las tasas de realización de pruebas y las tasas de detección en punción-aspiración con aguja fina y lesiones benignas (R²: 0,53), punción-aspiración con aguja fina y carcinoma invasivo (R²: 0, 28), biopsias cerradas y lesiones benignas (R²: 0,64), biopsias cerradas y carcinoma ductal in situ (R²: 0,61), y biopsias cerradas y carcinoma invasivo (R²: 0,48). Conclusiones: Se observaron variaciones en la realización de pruebas invasivas entre las unidades de detección precoz de cáncer de mama de mayor magnitud que las de detección de lesiones. Las unidades con más pruebas de punción-aspiración con aguja fina tienen mayores tasas de detección de lesiones benignas, y las que realizan más biopsias cerradas detectan más lesiones benignas y cáncer.

Objective: To describe how episodes of gender violence notified to the Registro de Atención Sanitaria en Violencia contra las Mujeres del Principado de Asturias (VIMPA) are registered in the clinical records of a health area of this geographical region. Methods: We performed a cross-sectional, descriptive study in a sample of cases collected in the VIMPA Registry in 2005 and 2006. The variables analyzed were the way in which the episode of gender violence was coded and registered, the presence of antecedents, and the diagnostic agreement among documents. Results: A total of 51.7% of primary care patients were attended in a center with access to their medical records. A specific International Classification of Primary Care-2 (World Organisation of National Colleges and Academics) code of abuse was used in only 15.1%, while a written diagnosis was used in all cases in specialized care. Conclusion: Episodes of gender violences were identified differently in distinct clinical documents. Our results point to the need for specific registries that would aid the combined use of distinct information sources.

Objetivo: Describir cómo se registran en los documentos clínico-asistenciales de una área sanitaria de Asturias los casos notificados al Registro de Atención Sanitaria en Violencia contra las Mujeres del Principado de Asturias (VIMPA). Métodos: Se realizó un estudio descriptivo transversal con una muestra de los casos recogidos en el Registro VIMPA durante los años 2005 y 2006. Como variables se tomaron la forma de codificación-registro del episodio, la presencia de antecedentes y la coincidencia de diagnósticos entre los documentos. Resultados: El 51,7% de las pacientes de atención primaria fueron atendidas en un centro con acceso a su historia clínica, y presentaban el código específico de maltrato de la Clasificación Internacional de la Atención Primaria el 15,1%. En atención especializada, todos los casos tuvieron referencia escrita. Conclusión: La identificación de casos entre los diferentes documentos es desigual. Los resultados apuntan a la necesidad de tener registros específicos que favorezcan la explotación combinada de las diferentes fuentes de información.

Objective: To describe how episodes of gender violence notified to the Registro de Atención Sanitaria en Violencia contra las Mujeres del Principado de Asturias (VIMPA) are registered in the clinical records of a health area of this geographical region. Methods: We performed a cross-sectional, descriptive study in a sample of cases collected in the VIMPA Registry in 2005 and 2006. The variables analyzed were the way in which the episode of gender violence was coded and registered, the presence of antecedents, and the diagnostic agreement among documents. Results: A total of 51.7% of primary care patients were attended in a center with access to their medical records. A specific International Classification of Primary Care-2 (World Organisation of National Colleges and Academics) code of abuse was used in only 15.1%, while a written diagnosis was used in all cases in specialized care. Conclusion: Episodes of gender violences were identified differently in distinct clinical documents. Our results point to the need for specific registries that would aid the combined use of distinct information sources.

Objetivo: Describir cómo se registran en los documentos clínico-asistenciales de una área sanitaria de Asturias los casos notificados al Registro de Atención Sanitaria en Violencia contra las Mujeres del Principado de Asturias (VIMPA). Métodos: Se realizó un estudio descriptivo transversal con una muestra de los casos recogidos en el Registro VIMPA durante los años 2005 y 2006. Como variables se tomaron la forma de codificación-registro del episodio, la presencia de antecedentes y la coincidencia de diagnósticos entre los documentos. Resultados: El 51,7% de las pacientes de atención primaria fueron atendidas en un centro con acceso a su historia clínica, y presentaban el código específico de maltrato de la Clasificación Internacional de la Atención Primaria el 15,1%. En atención especializada, todos los casos tuvieron referencia escrita. Conclusión: La identificación de casos entre los diferentes documentos es desigual. Los resultados apuntan a la necesidad de tener registros específicos que favorezcan la explotación combinada de las diferentes fuentes de información.

OBJETIVO: Estudar a fauna de culicídeos adultos em uma área de reserva na periferia urbana para definir as espécies de interesse em saúde pública. MÉTODOS: O estudo foi realizado no Parque Ecológico do Tietê, localizado na periferia urbana da Grande São Paulo, Brasil. Realizaram-se coletas mensais em três locais e horários distintos, com o uso de aspiradores elétricos, armadilhas CDC e de Shannon no período de agosto de 1996 até março de 1998. O tratamento dos dados baseou-se na estimativa de freqüências e abundâncias. RESULTADOS: Coletaram-se 53.496 exemplares, tendo sido reconhecidas 25 espécies ou grupos genéricos. As espécies Ochlerotatus scapularis, Culex quinquefasciatus e Culex declarator foram as mais freqüentes e abundantes. CONCLUSÕES: As espécies mais freqüentes e abundantes têm demonstrado eficiência na transmissão de agentes patogênicos ao homem em outras regiões. Atenção deve ser dada a esses culicídeos, pois o o local investigado, ao lado de um complexo urbano, reúne condições favoráveis à disseminação de doenças por vetores.

OBJECTIVE: To study the adult Culicidae fauna in a preserved area in urban outskirts for describing species of public health concern. METHODS: This study was developed in the Tietê Ecological Park located in the outskirt of the city of São Paulo, Brazil. Monthly collections were undertaken in three habitats at different times using electric aspirators and CDC and Shannon traps from August 1996 to March 1998. Data analysis was based on estimates of frequencies and abundance. RESULTS: Twenty-five species or generic groups were identified among 53,496 specimens collected. Ochlerotatus scapularis, Culex quinquefasciatus, and Culex declarator were the most frequent and abundant species. CONCLUSIONS: The most frequent and abundant species have been implicated in disease transmission to man in other regions. Attention must be given to these Culicidae since the study area is located near to an urban center, which could amplify the conditions for spreading vector diseases.

OBJETIVO: Estudar a fauna de culicídeos adultos em uma área de reserva na periferia urbana para definir as espécies de interesse em saúde pública. MÉTODOS: O estudo foi realizado no Parque Ecológico do Tietê, localizado na periferia urbana da Grande São Paulo, Brasil. Realizaram-se coletas mensais em três locais e horários distintos, com o uso de aspiradores elétricos, armadilhas CDC e de Shannon no período de agosto de 1996 até março de 1998. O tratamento dos dados baseou-se na estimativa de freqüências e abundâncias. RESULTADOS: Coletaram-se 53.496 exemplares, tendo sido reconhecidas 25 espécies ou grupos genéricos. As espécies Ochlerotatus scapularis, Culex quinquefasciatus e Culex declarator foram as mais freqüentes e abundantes. CONCLUSÕES: As espécies mais freqüentes e abundantes têm demonstrado eficiência na transmissão de agentes patogênicos ao homem em outras regiões. Atenção deve ser dada a esses culicídeos, pois o o local investigado, ao lado de um complexo urbano, reúne condições favoráveis à disseminação de doenças por vetores.

OBJECTIVE: To study the adult Culicidae fauna in a preserved area in urban outskirts for describing species of public health concern. METHODS: This study was developed in the Tietê Ecological Park located in the outskirt of the city of São Paulo, Brazil. Monthly collections were undertaken in three habitats at different times using electric aspirators and CDC and Shannon traps from August 1996 to March 1998. Data analysis was based on estimates of frequencies and abundance. RESULTS: Twenty-five species or generic groups were identified among 53,496 specimens collected. Ochlerotatus scapularis, Culex quinquefasciatus, and Culex declarator were the most frequent and abundant species. CONCLUSIONS: The most frequent and abundant species have been implicated in disease transmission to man in other regions. Attention must be given to these Culicidae since the study area is located near to an urban center, which could amplify the conditions for spreading vector diseases.

OBJETIVO: Estudar a população de Aedes aegypti em área de transmissão de dengue sob o ponto de vista de freqüência, distribuição espacial, paridade, desenvolvimento ovariano e conteúdo do intestino médio. MÉTODOS: O estudo foi realizado na cidade de São José do Rio Preto, SP. Foram selecionados dois setores, um com nível socioeconômico baixo e outro com nível médio. As observações foram realizadas entre 1996 e 1997. Foram feitas capturas no intra e peridomicílios com capturadores elétricos manuais. São dados detalhes das dissecções para estudo do estado fisiológico das fêmeas e da classificação utilizada. RESULTADOS: Capturaram-se 188 machos e 189 fêmeas. Obteve-se um índice de 0,46 fêmeas por casa. Dos machos e das fêmeas capturados, estavam no intradomicílio, respectivamente, 82,4% e 87,3%. Encontrou-se maior proporção de fêmeas no setor de nível socioeconômico mais baixo e com maior concentração populacional. Foram analisadas 148 fêmeas, sendo 27,0% nulíparas e 10,1% oníparas. As demais foram classificadas nas fases III a V de Christophers e Mer (C & M) com 28,0% destas contendo sangue de coloração vermelha no intestino médio. Das fêmeas, 87,9% já haviam praticado a hematofagia. CONCLUSÕES: A espécie revelou grande tendência à endofilia. A proporção de nulíparas foi superior a de oníparas, apesar da maioria das fêmeas ser classificada nas fases III a V de C & M. Chama atenção o elevado percentual das fêmeas que praticaram a hematofagia e a ocorrência de não concordância gonotrófica.

OBJECTIVE: A Aedes aegypti population from an area of dengue transmission was studied to determine mosquito's frequency, spatial distribution, parity, its ovarian development and midgut contents. METHODS: The study carried out in São José do Rio Preto country, São Paulo, SP, Brazil. Low and intermediate socioeconomic level regions were chosen to the study, which was carried out 1996 and 1997. Using a manual electric aspirator, captures were performed inside and outside the houses. Dissections were conducted to allow classify female mosquitoes according to their physiologic state. RESULTS: One hundred and eighty-eight males and 189 females were captured in both regions. A general index of 0.46 Ae. aegypti females per house was determined. Of the total sample, 82.4% of males and 87.3% of females were collected indoors. Greater proportions of females were found in the region of low socioeconomic level, and higher population density. One hundred and forty-eight female mosquitoes were analyzed: 27.0% were nulliparous and 10.1% parous. The rest were classified as Christophers and Mer's (C & M) phases III to V, 28.0% of which had red blood in their midgut. Of the total female population, 87.9% had bloodmeals. CONCLUSIONS: The mosquito species revealed a high degree of endophily. There was a higher proportion of nulliparous mosquitoes, although the majority of the females were classified as C & M's phases III to V. These results highlight both the great number of females who had had bloodmeals, and the lack of gonotrophic concordance.

OBJETIVO: Estudar a população de Aedes aegypti em área de transmissão de dengue sob o ponto de vista de freqüência, distribuição espacial, paridade, desenvolvimento ovariano e conteúdo do intestino médio. MÉTODOS: O estudo foi realizado na cidade de São José do Rio Preto, SP. Foram selecionados dois setores, um com nível socioeconômico baixo e outro com nível médio. As observações foram realizadas entre 1996 e 1997. Foram feitas capturas no intra e peridomicílios com capturadores elétricos manuais. São dados detalhes das dissecções para estudo do estado fisiológico das fêmeas e da classificação utilizada. RESULTADOS: Capturaram-se 188 machos e 189 fêmeas. Obteve-se um índice de 0,46 fêmeas por casa. Dos machos e das fêmeas capturados, estavam no intradomicílio, respectivamente, 82,4% e 87,3%. Encontrou-se maior proporção de fêmeas no setor de nível socioeconômico mais baixo e com maior concentração populacional. Foram analisadas 148 fêmeas, sendo 27,0% nulíparas e 10,1% oníparas. As demais foram classificadas nas fases III a V de Christophers e Mer (C & M) com 28,0% destas contendo sangue de coloração vermelha no intestino médio. Das fêmeas, 87,9% já haviam praticado a hematofagia. CONCLUSÕES: A espécie revelou grande tendência à endofilia. A proporção de nulíparas foi superior a de oníparas, apesar da maioria das fêmeas ser classificada nas fases III a V de C & M. Chama atenção o elevado percentual das fêmeas que praticaram a hematofagia e a ocorrência de não concordância gonotrófica.

OBJECTIVE: A Aedes aegypti population from an area of dengue transmission was studied to determine mosquito's frequency, spatial distribution, parity, its ovarian development and midgut contents. METHODS: The study carried out in São José do Rio Preto country, São Paulo, SP, Brazil. Low and intermediate socioeconomic level regions were chosen to the study, which was carried out 1996 and 1997. Using a manual electric aspirator, captures were performed inside and outside the houses. Dissections were conducted to allow classify female mosquitoes according to their physiologic state. RESULTS: One hundred and eighty-eight males and 189 females were captured in both regions. A general index of 0.46 Ae. aegypti females per house was determined. Of the total sample, 82.4% of males and 87.3% of females were collected indoors. Greater proportions of females were found in the region of low socioeconomic level, and higher population density. One hundred and forty-eight female mosquitoes were analyzed: 27.0% were nulliparous and 10.1% parous. The rest were classified as Christophers and Mer's (C & M) phases III to V, 28.0% of which had red blood in their midgut. Of the total female population, 87.9% had bloodmeals. CONCLUSIONS: The mosquito species revealed a high degree of endophily. There was a higher proportion of nulliparous mosquitoes, although the majority of the females were classified as C & M's phases III to V. These results highlight both the great number of females who had had bloodmeals, and the lack of gonotrophic concordance.

Foram coletadas larvas de Aedes albopictus em uma planta da família Bromeliaceae, na periferia da cidade de São Paulo, SP, Brasil. Esse encontro abre perspectivas de estudo para avaliação do potencial desse vegetal como criadouro desse mosquito no País.

Larvae of Aedes albopictus from a plant of the Bromeliaceae family on the outskirts of S. Paulo, SP, Brazil, were collected. This occurrence sheds new light on the attempt to determine the potential of this plants as a breeding site for this mosquito in Brazil.

Foram coletadas larvas de Aedes albopictus em uma planta da família Bromeliaceae, na periferia da cidade de São Paulo, SP, Brasil. Esse encontro abre perspectivas de estudo para avaliação do potencial desse vegetal como criadouro desse mosquito no País.

Larvae of Aedes albopictus from a plant of the Bromeliaceae family on the outskirts of S. Paulo, SP, Brazil, were collected. This occurrence sheds new light on the attempt to determine the potential of this plants as a breeding site for this mosquito in Brazil.

Foram feitas coletas de mosquito (Diptera: Culicidae) na área do projeto de Colonização Pedro Peixoto, no Estado do Acre, Brasil. Obteve-se um total de 4.588 exemplares pertencentes a 53 espécies ou grupos. Salienta-se a ocorrência de Anopheles (Nyssorhynchus) oswaldoi.

Mosquito (Diptera: Culicidae) collections were made on the Pedro Peixoto Colonization Project in the State of Acre, Brazil. Four thousand, five hundred and eighty-eight (4,588) specimens were collected and fifty-three (53) species or group recognised. The occurrence of Anopheles (Nyssorhynchus) oswaldoi is given special emphasis.

Foram feitas coletas de mosquito (Diptera: Culicidae) na área do projeto de Colonização Pedro Peixoto, no Estado do Acre, Brasil. Obteve-se um total de 4.588 exemplares pertencentes a 53 espécies ou grupos. Salienta-se a ocorrência de Anopheles (Nyssorhynchus) oswaldoi.

Mosquito (Diptera: Culicidae) collections were made on the Pedro Peixoto Colonization Project in the State of Acre, Brazil. Four thousand, five hundred and eighty-eight (4,588) specimens were collected and fifty-three (53) species or group recognised. The occurrence of Anopheles (Nyssorhynchus) oswaldoi is given special emphasis.