Uso de um sistema de informações geográficas para a base de dados dos solos brasileiros.

O objetivo deste trabalho é estruturar a base de solos da Bacia do Alto Paraguai (BAP), na escala 1:1.000.000, utilizando o Sistema de Processamento de Informações Georreferenciadas - SPRING. Esta etapa faz parte de um projeto maior da Embrapa Informática Agropecuária que objetiva inserir a base de solo brasileira em um Sistema de Informações Geográficas. Atualmente a base de solos do Brasil nessa escala recobre um pouco mais de 91% do território, sendo publicados em 35 volumes pelo projeto Radam e IBGE, recobrindo 47 folhas ao milionésimo. As folhas ao milionésimo foram adquiridas do IBGE em meio digital e formato PDF. Esses mapas foram georreferenciados e digitalizados no SPRING via ampliações tela do computador. Como resultado obteve-se a base digital georreferenciada ao milionésimo dos solos brasileiro, cujo produto para a BAP é apresentado neste artigo. Esta base encontra-se atributada no sistema de classificação de solo original. Além disso, os textos estão devidamente ajustados a cada polígono mapeado. Para cada mapa digitalizado elaborou-se um relatório com a identificação das principais ocorrências de desconfomidades, saber: polígono sem classificação, polígono com duas classes, polígono sem fechamento e sobreposição de informação. No caso da BAP somente as desconformidades do tipo polígono sem classificação e polígono com duas classes foram observados.Geopantanal 2006

Desmatamento no bioma Pantanal até o ano 2002: relações com a fitofisionomia e limites municipais.

O objetivo deste trabalho é mapear e quantificar a área desmatada no Bioma Pantanal ocorrida até o ano de 2002, relacionando-a às principais classes fisionômicas de vegetação e aos municípios formadores do Pantanal

Análise do desmatamento no bioma Pantanal até o ano de 2002.

O objetivo deste trabalho é mapear e quantificar a área desmaiada no Bioma Pantanal ocorrida até o ano de 2002, relacionando-a às principais classes fisionómicas de vegetação e aos municípios formadores do Pantanal. O Bioma Pantanal situa-se na região Centro-Oeste, inserido na bacia hidrográfica do Alto rio Paraguai (BAP), que por sua vez está inserida na bacia do Prata. Para compor a área do Pantanal foram necessárias 16 imagens de satélite Landsat-ETM+ e 20 cartas topográficas na escala de 1:250.000. Inicialmente foi elaborado um mosaico do Pantanal composto pelas 16 imagens nas bandas 3, 4 e 5 utilizando o software Envi-4.0. Em seguida foi realizada uma segmentação utilizando-se o software SPRING. Após esse procedimento a área do Bioma Pantanal foi recortada para cada uma das 20 cartas topográficas na escala de 1:250000, dentro dos limites definidos pelo IBGE. O processo de interpretação do desmatamento foi realizado com ampliações da imagem na tela do computador, utilizando o SIG SPRING, o qual foi efetuado após os procedimentos de edição das cartas para a realização de limpeza e generalização dos polígonos de acordo com os temas a serem classificados. Adotou-se o Sistema Fisionômico-ecológico para classificação da vegetação, acrescido de novas informações, quando necessário. Na interpretação das imagens foram considerados os elementos textura, cor, padrão, forma e localização (distribuição geográfica) e os levantamentos efetuados durante os trabalhos de campo na região do Pantanal. Os mapas de desmatamento foram gerados no sistema de projeção cartográfica UTM (Universal Transversa de Mercator), com Datum SAD69 (South América Datum). O erro admitido para o georreferenciamento das imagens de satélite ficou dentro da precisão do erro cartográfico (PEC) admitido para cartas na escala de 1:250.000, que é de 125 metros. A menor área mapeada foi em tomo de 40 ha.Geopantanal 2006

Heart failure and the risk of stroke: the Rotterdam Study

Patients with heart failure used to have an increased risk of stroke, but this may have changed with current treatment regimens. We assessed the association between heart failure and the risk of stroke in a population-based cohort that was followed since 1990. The study uses the cohort of the Rotterdam Study and is based on 7,546 participants who at baseline (1990–1993) were aged 55 years or over and free from stroke. The associations between heart failure and risk of stroke were assessed using time-dependent Cox proportional hazards models, adjusted for cardiovascular risk factors (smoking, diabetes mellitus, BMI, ankle brachial index, blood pressure, atrial fibrillation, myocardial infarction and relevant medication). At baseline, 233 participants had heart failure. During an average follow-up time of 9.7 years, 1,014 persons developed heart failure, and 827 strokes (470 ischemic, 75 hemorrhagic, 282 unclassified) occurred. The risk of ischemic stroke was more than five-fold increased in the first month after diagnosis of heart failure (age and sex adjusted HR 5.79, 95% CI 2.15–15.62), but attenuated over time (age and sex adjusted HR 3.50 [95% CI 1.96–6.25] after 1–6 months and 0.83 [95% CI 0.53–1.29] after 0.5–6 years). Additional adjustment for cardiovascular risk factors only marginally attenuated these risks. In conclusion, the risk of ischemic stroke is strongly increased shortly after the diagnosis of heart failure but returns to normal within 6 months after onset of heart failure

National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

<p>Abstract</p> <p>Background</p> <p>Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC), and high body mass index (BMI) on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods.</p> <p>Methods</p> <p>We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework.</p> <p>Results</p> <p>In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000) deaths in men and 39,000 (36,000, 42,000) deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9) and 4.1 years (3.2, 4.9) in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions.</p> <p>Discussion</p> <p>Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran. Interventions for other metabolic risk factors and smoking can also improve population health.</p

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background Liraglutide 3\ub70 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3\ub70 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2\ub77 times longer with liraglutide than with placebo (95% CI 1\ub79 to 3\ub79, p<0\ub70001), corresponding with a hazard ratio of 0\ub721 (95% CI 0\ub713\u20130\ub734). Liraglutide induced greater weight loss than placebo at week 160 (\u20136\ub71 [SD 7\ub73] vs 121\ub79% [6\ub73]; estimated treatment difference 124\ub73%, 95% CI 124\ub79 to 123\ub77, p<0\ub70001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3\ub70 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding Novo Nordisk, Denmark

A randomized, controlled trial of 3.0 mg of liraglutide in weight management

BACKGROUND Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagonlike peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously. METHODS We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension. We randomly assigned patients in a 2:1 ratio to receive once-daily subcutaneous injections of liraglutide at a dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups received counseling on lifestyle modification. The coprimary end points were the change in body weight and the proportions of patients losing at least 5% and more than 10% of their initial body weight. RESULTS At baseline, the mean (±SD) age of the patients was 45.1±12.0 years, the mean weight was 106.2±21.4 kg, and the mean BMI was 38.3±6.4; a total of 78.5% of the patients were women and 61.2% had prediabetes. At week 56, patients in the liraglutide group had lost a mean of 8.4±7.3 kg of body weight, and those in the placebo group had lost a mean of 2.8±6.5 kg (a difference of -5.6 kg; 95% confidence interval, -6.0 to -5.1; P&lt;0.001, with last-observation-carried-forward imputation). A total of 63.2% of the patients in the liraglutide group as compared with 27.1% in the placebo group lost at least 5% of their body weight (P&lt;0.001), and 33.1% and 10.6%, respectively, lost more than 10% of their body weight (P&lt;0.001). The most frequently reported adverse events with liraglutide were mild or moderate nausea and diarrhea. Serious events occurred in 6.2% of the patients in the liraglutide group and in 5.0% of the patients in the placebo group. CONCLUSIONS In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. (Funded by Novo Nordisk; SCALE Obesity and Prediabetes NN8022-1839 ClinicalTrials.gov number, NCT01272219.)