Flávio Henrique Miranda de Araújo Freire

Comparing reconstruction with ileocecal graft to jejunal interposition pouch after total gastrectomy in rats.

After total gastrectomy, the ileocecal graft may act as a reservoir and protect against reflux but give rise to transposition of the ileum and cause possible changes in bile acid metabolism and nutrition. This study compared the ileocecal graft and jejunal pouch. Male Wistar rats weighing 265 ± 22 g were submitted to sham operation (S), ileocecal interposition graft (IIG), and jejunal pouch interposition graft (JP) after total gastrectomy. Eight weeks later, the esophagus was examined for evidence of esophagitis. Nutritional biochemistry and weight profile were documented preoperatively and 8 weeks after surgery. The oral glucose tolerance test was performed. Thirty-three rats were operated on and 30 survived for 8 weeks. Esophagitis occurred in seven JP rats. Body weight was significantly higher in IIG than in JP rats (p <. 05). Normal glucose tolerance to intragastric glucose load was observed in sham and operated rats. JP rats had a significant decrease in serum albumin, glucose, transferrin, hemoglobin, iron, folate, and calcium, compared to sham (p <. 05). Cobalamine was significantly lower in IIG rats than in JP rats (p <. 05). In the IIG and JP groups, serum/hepatic total bile acid did not differ significantly from preoperative and sham values. In conclusion, the IIG interposition graft in rats prevented esophagitis, preserved nutrition, and did not interfere with enterohepatic total bile acid circulation.

Estimativas do grau de cobertura e da mortalidade adulta (45q15) para as unidades da federação no Brasil entre 1980 e 2010

Objective: Assess the completeness of the DataSUS SIM death-count registry, by sex and Brazilian state, and estimate the probability of adult mortality (45q15), by sex and state, from 1980 to 2010. Methods: The study was based on mortality data obtained in the DataSUS Mortality Information System, from 1980 to 2010, and on population data from the 1980, 1991, 2000, and 2010 demographic censuses. The quality assessment of the registry data was conducted using traditional demographic and death distribution methods, and death probabilities were calculated using life-table concepts. Results: The results show a considerable improvement in the completeness of the death-count coverage in Brazil since 1980. In the southeast and south, we observed the complete coverage of the adult mortality registry, which did not occur in the previous decade. In the northeast and north, there were still places with a low coverage from 2000 to 2010, although there was a clear improvement in the quality of data. For all Brazilian states, there was a decline in the probability of adult mortality; we observed, however, that the death probability for males is much higher than that for females throughout the whole analysis period. Conclusion: The observed improvements seem to be related to investments in the public health care system and administrative procedures to improve the recording of vital events.

Estimação de sub-registros de óbitos em pequenas áreas com os métodos bayesiano empírico e algoritmo EM

Un gran problema, en lo que se refiere a estimativas demograficas en Brasil, esta relacionado con el nivel y patron de la mortalidad. Los demografos que trabajan con mortalidad en el pais todavia no se sienten muy seguros sobre el comportamiento real de este componente de la dinamica poblacional. Por otro lado, es necesario que se disponga de indicadores de mortalidad para niveles geograficos mas desagregados, sobre todo municipios. El problema es que cuanto mas desagregado, mas complejo se hace el trabajo de estimar cualquier indicador social o demografico. Este trabajo tiene por objetivo estimar y proponer una correccion de subregistros de fallecimientos en el nivel municipal, segun grupos de edad, por medio de dos metodos: estimador bayesiano empirico (BE) y algoritmo EM (Expectation-Maximization). Con el objeto de que los dos metodos fueran puestos en funcionamiento entre municipios semejantes, se realizaron dos ejercicios: se agruparon los municipios segun la mesorregion; y se agruparon los municipios en grupos homogeneos, generados a partir de un analisis de cluster, utilizando las variables grado de urbanizacion, proporcion de obitos por causas externas y la poblacion de cada municipio. Se utilizaron datos del Estado de Rio Grande do Norte, referentes al ano 2000. Para el total del Estado, se estimo un subregistro de un 11% con el estimador BE y de un 12,9% con el algoritmo EM. Otro resultado importante es la posibilidad de evaluar el grado de cobertura de obitos por grupos de edad en municipios y en cualquier nivel de agregacion a partir de este nivel.

Adult mortality estimates for small areas in Brazil, 1980–2010: a methodological approach

Abstract Background In recent decades, life expectancy and health status have improved considerably in Brazil. Life expectancy at birth has risen from 48 years in 1960 to over 73 years in 2010. However, the country is marked by large regional and socioeconomic inequality. Due to data limitations, incomplete coverage of vital registration systems, and errors in age declaration for both population and death counts, little is known about the level and trends in adult mortality for sub-national areas. This study aimed to study the evolution of adult mortality in small areas in Brazil from 1980 to 2010, using 45q15 as a summary measure of adult mortality across small areas in Brazil. Methods Data were obtained from the mortality database available from Datasus, a vital statistics database organised by the Brazilian Ministry of Health that contains information on deaths by age, sex, and cause from 1979 to 2010. Population censuses were used to acquire the population by age and sex for 137 comparable small areas in Brazil, as defined by the National Statistics Office, for the years 1980 to 2010. We combined traditional formal demography methods, called death distribution methods, with indirect standardisation and Bayesian statistics to produce more reliable estimates of adult mortality for the 137 small areas. Findings The results show that data quality has improved considerably across Brazil during the period of analysis, but regional variation persists. On average, completeness of death counts increased from 80% (range 50–100) in 1980–91, to 95% (73–100) in 2000–10. Estimates of adult mortality show that more developed regions in the south and southeast parts of the country have lower mortality levels than the northeast, but there is a clear convergence process. Interpretation This study indicates that the combination of traditional demographic methods to Bayesian statistics is a successful alternative to produce mortality estimates for small areas in Brazil. We also found a large improvement in the quality of mortality data in Brazil since 1980. Finally, we observe a convergence process on health status. Funding Brazilian National Counsel of Technological and Scientific Development (CNPq) and Minas Gerais Research Foundation (Fapemig).

Diferenciales de mortalidad por escolaridad en la población adulta brasileña en 2010

This study aims to estimate mortality differentials by level of schooling in the adult population in Brazil as a whole and its major geographic regions, according to sex and age. The article uses data from the item on household mortality in the 2010 Population Census conducted by Brazilian Institute of Geography and Statistics, combined with information on schooling of the households reference person. The results show an important mortality differential by level of schooling, especially in males. Life expectancy in Brazilian men with a complete university education is 4.37 years more than the mean for the national male population and 6.27 years more than for males with less than a complete primary education. Among women, the educational gradient in life expectancy is less pronounced, with an additional 2.25 years for women with a complete university education, compared to women with less schooling. Mortality differentials according to schooling are more pronounced in the Northeast and Southeast regions.Este trabalho tem por objetivo estimar os diferenciais de mortalidade por nivel de escolaridade da populacao adulta do Brasil e suas regioes, segundo sexo e idade. O artigo utiliza os dados do novo quesito de mortalidade domiciliar do Censo Demografico de 2010 do Instituto Brasileiro de Geografia e Estatistica, combinado com as informacoes do nivel de escolaridade da pessoa de referencia do domicilio. Os resultados indicam um consideravel diferencial de mortalidade por grau de escolaridade, particularmente entre a populacao masculina. A expectativa de vida de homens com o ensino superior completo no Brasil era 4,37 anos maior do que a media da populacao masculina nacional, e 6,27 anos maior do que a da populacao masculina com menos do que o Ensino Fundamental completo. Entre a populacao feminina, o gradiente educacional de expectativa de vida e menos acentuado, com um adicional de 2,25 anos na expectativa de vida de mulheres com o Ensino Superior completo em comparacao as com menor nivel de escolaridade. Os diferenciais de mortalidade por educacao aparecem mais acentuados nas regioes Nordeste e Sudeste.

Mortality differentials according to schooling in Brazilian adults in 2010

This study aims to estimate mortality differentials by level of schooling in the adult population in Brazil as a whole and its major geographic regions, according to sex and age. The article uses data from the item on household mortality in the 2010 Population Census conducted by Brazilian Institute of Geography and Statistics, combined with information on schooling of the households reference person. The results show an important mortality differential by level of schooling, especially in males. Life expectancy in Brazilian men with a complete university education is 4.37 years more than the mean for the national male population and 6.27 years more than for males with less than a complete primary education. Among women, the educational gradient in life expectancy is less pronounced, with an additional 2.25 years for women with a complete university education, compared to women with less schooling. Mortality differentials according to schooling are more pronounced in the Northeast and Southeast regions.Este trabalho tem por objetivo estimar os diferenciais de mortalidade por nivel de escolaridade da populacao adulta do Brasil e suas regioes, segundo sexo e idade. O artigo utiliza os dados do novo quesito de mortalidade domiciliar do Censo Demografico de 2010 do Instituto Brasileiro de Geografia e Estatistica, combinado com as informacoes do nivel de escolaridade da pessoa de referencia do domicilio. Os resultados indicam um consideravel diferencial de mortalidade por grau de escolaridade, particularmente entre a populacao masculina. A expectativa de vida de homens com o ensino superior completo no Brasil era 4,37 anos maior do que a media da populacao masculina nacional, e 6,27 anos maior do que a da populacao masculina com menos do que o Ensino Fundamental completo. Entre a populacao feminina, o gradiente educacional de expectativa de vida e menos acentuado, com um adicional de 2,25 anos na expectativa de vida de mulheres com o Ensino Superior completo em comparacao as com menor nivel de escolaridade. Os diferenciais de mortalidade por educacao aparecem mais acentuados nas regioes Nordeste e Sudeste.

Diferenciais de mortalidade por escolaridade da população adulta brasileira, em 2010

This study aims to estimate mortality differentials by level of schooling in the adult population in Brazil as a whole and its major geographic regions, according to sex and age. The article uses data from the item on household mortality in the 2010 Population Census conducted by Brazilian Institute of Geography and Statistics, combined with information on schooling of the households reference person. The results show an important mortality differential by level of schooling, especially in males. Life expectancy in Brazilian men with a complete university education is 4.37 years more than the mean for the national male population and 6.27 years more than for males with less than a complete primary education. Among women, the educational gradient in life expectancy is less pronounced, with an additional 2.25 years for women with a complete university education, compared to women with less schooling. Mortality differentials according to schooling are more pronounced in the Northeast and Southeast regions.Este trabalho tem por objetivo estimar os diferenciais de mortalidade por nivel de escolaridade da populacao adulta do Brasil e suas regioes, segundo sexo e idade. O artigo utiliza os dados do novo quesito de mortalidade domiciliar do Censo Demografico de 2010 do Instituto Brasileiro de Geografia e Estatistica, combinado com as informacoes do nivel de escolaridade da pessoa de referencia do domicilio. Os resultados indicam um consideravel diferencial de mortalidade por grau de escolaridade, particularmente entre a populacao masculina. A expectativa de vida de homens com o ensino superior completo no Brasil era 4,37 anos maior do que a media da populacao masculina nacional, e 6,27 anos maior do que a da populacao masculina com menos do que o Ensino Fundamental completo. Entre a populacao feminina, o gradiente educacional de expectativa de vida e menos acentuado, com um adicional de 2,25 anos na expectativa de vida de mulheres com o Ensino Superior completo em comparacao as com menor nivel de escolaridade. Os diferenciais de mortalidade por educacao aparecem mais acentuados nas regioes Nordeste e Sudeste.

Estimación de subregistros de fallecimientos en pequeñas áreas con los métodos bayesiano empírico y algoritmo EM

Un gran problema, en lo que se refiere a estimativas demograficas en Brasil, esta relacionado con el nivel y patron de la mortalidad. Los demografos que trabajan con mortalidad en el pais todavia no se sienten muy seguros sobre el comportamiento real de este componente de la dinamica poblacional. Por otro lado, es necesario que se disponga de indicadores de mortalidad para niveles geograficos mas desagregados, sobre todo municipios. El problema es que cuanto mas desagregado, mas complejo se hace el trabajo de estimar cualquier indicador social o demografico. Este trabajo tiene por objetivo estimar y proponer una correccion de subregistros de fallecimientos en el nivel municipal, segun grupos de edad, por medio de dos metodos: estimador bayesiano empirico (BE) y algoritmo EM (Expectation-Maximization). Con el objeto de que los dos metodos fueran puestos en funcionamiento entre municipios semejantes, se realizaron dos ejercicios: se agruparon los municipios segun la mesorregion; y se agruparon los municipios en grupos homogeneos, generados a partir de un analisis de cluster, utilizando las variables grado de urbanizacion, proporcion de obitos por causas externas y la poblacion de cada municipio. Se utilizaron datos del Estado de Rio Grande do Norte, referentes al ano 2000. Para el total del Estado, se estimo un subregistro de un 11% con el estimador BE y de un 12,9% con el algoritmo EM. Otro resultado importante es la posibilidad de evaluar el grado de cobertura de obitos por grupos de edad en municipios y en cualquier nivel de agregacion a partir de este nivel.

Estimation of death underreporting at small areas using empiric Bayesian and EM algorithm methods

Un gran problema, en lo que se refiere a estimativas demograficas en Brasil, esta relacionado con el nivel y patron de la mortalidad. Los demografos que trabajan con mortalidad en el pais todavia no se sienten muy seguros sobre el comportamiento real de este componente de la dinamica poblacional. Por otro lado, es necesario que se disponga de indicadores de mortalidad para niveles geograficos mas desagregados, sobre todo municipios. El problema es que cuanto mas desagregado, mas complejo se hace el trabajo de estimar cualquier indicador social o demografico. Este trabajo tiene por objetivo estimar y proponer una correccion de subregistros de fallecimientos en el nivel municipal, segun grupos de edad, por medio de dos metodos: estimador bayesiano empirico (BE) y algoritmo EM (Expectation-Maximization). Con el objeto de que los dos metodos fueran puestos en funcionamiento entre municipios semejantes, se realizaron dos ejercicios: se agruparon los municipios segun la mesorregion; y se agruparon los municipios en grupos homogeneos, generados a partir de un analisis de cluster, utilizando las variables grado de urbanizacion, proporcion de obitos por causas externas y la poblacion de cada municipio. Se utilizaron datos del Estado de Rio Grande do Norte, referentes al ano 2000. Para el total del Estado, se estimo un subregistro de un 11% con el estimador BE y de un 12,9% con el algoritmo EM. Otro resultado importante es la posibilidad de evaluar el grado de cobertura de obitos por grupos de edad en municipios y en cualquier nivel de agregacion a partir de este nivel.