Acute phenylalanine and tyrosine depletion (APTD) studies have been used to assess the role of the cathecholaminergic system in various aspects of human behaviour. In this study we conducted a randomized, double-blind, controlled and cross-over comparison to evaluate the effects of APTD on memory, attention and mood in normal subjects. Twelve healthy male volunteers were included in this study. The subjects ingested a nutritionally balanced mixture (B) or a similar mixture deficient in phenylalanine and tyrosine (PT-). Before and 5 h after ingestion of the drink, volunteers underwent tests on mood, memory and attention. Results of the memory tests showed that PT- mixture impaired word recall as measured in Rey's test (p = 0.016). The assessment of changes in mood showed that the balanced mixture improved scores of as alertness (VAMS factor I, p = 0.037) and the PT- mixture induces an opposite effect, increased scores of anxiety (Profiles of Mental State composed-anxious dimension, p = 0.022). These results suggest that tyrosine plasma levels and cathecholamines may be important factors in regulating mood and memory.

DescritoresIniqüidade na saúde. Mortalidade infantil, tendências. Coeficiente de mortalidade. Mortalidade neonatal (saúde pública). Taxas de escolaridade feminina. Abstract ObjectiveTo determine the trends of infant mortality from 1995 to 1999 according to a geographic area-based measure of maternal education in Porto Alegre, Brazil. Methods A registry-based study was carried out and a municipal database created in 1994 was used. All live births (n=119,170) and infant deaths (n=1,934) were considered. Five different geographic areas were defined according to quintiles of the percentage of low maternal educational level (<6 years of schooling): high, medium high, medium, medium low, and low. The chi-square test for trend was used to compare rates between years. Incidence rate ratio was calculated using Poisson regression to identify excess infant mortality in poorer areas compared to higher schooling areas. ResultsThe infant mortality rate (IMR) decreased steadily from 18.38 deaths per 1,000 live births in 1995 to 12.21 in 1999 (chi-square for trend p<0.001). Both neonatal and post-neonatal mortality rates decreased although the drop seemed to be steeper for the post-neonatal component. The higher decline was seen in poorer areas. Conclusion Inequalities in IMR seem to have decreased due to a steeper reduction in both neonatal and post-neonatal components of infant mortality in lower maternal schooling area. ResumoObjetivo Determinar as tendências da mortalidade infantil de 1995 a 1999, segundo a escolaridade materna, medidas em base geográfica, em Porto Alegre, Brasil. Métodos Estudo baseado em dados secundários de um banco de dados municipal, criado em 1994. Todos os nascidos vivos (119.170 nascimentos) e óbitos infantis (1.934 óbitos) foram considerados. Foram definidas cinco diferentes áreas geográficas segundo os quintis de percentagem de escolaridade materna baixa (menos de seis anos de estudo): alta, médio-alta, média, média-baixa e baixa escolaridade. Foi usado o teste do qui-quadrado para tendências de comparação das taxas entre as áreas. Foi calculada a razão de incidências pela regressão de Poisson para identificar excesso 2002;36(4):478-83 www.fsp.usp.br/rsp4 7 9 4 7 9 4 7 9 4 7 9 4 7 9 Rev Saúde Pública Infant mortality in Southern BrazilGoldani MZ et al. de mortalidade infantil nas áreas mais pobres, em comparação com as mais ricas.

DescritoresIniqüidade na saúde. Mortalidade infantil, tendências. Coeficiente de mortalidade. Mortalidade neonatal (saúde pública). Taxas de escolaridade feminina. Abstract ObjectiveTo determine the trends of infant mortality from 1995 to 1999 according to a geographic area-based measure of maternal education in Porto Alegre, Brazil. Methods A registry-based study was carried out and a municipal database created in 1994 was used. All live births (n=119,170) and infant deaths (n=1,934) were considered. Five different geographic areas were defined according to quintiles of the percentage of low maternal educational level (<6 years of schooling): high, medium high, medium, medium low, and low. The chi-square test for trend was used to compare rates between years. Incidence rate ratio was calculated using Poisson regression to identify excess infant mortality in poorer areas compared to higher schooling areas. ResultsThe infant mortality rate (IMR) decreased steadily from 18.38 deaths per 1,000 live births in 1995 to 12.21 in 1999 (chi-square for trend p<0.001). Both neonatal and post-neonatal mortality rates decreased although the drop seemed to be steeper for the post-neonatal component. The higher decline was seen in poorer areas. Conclusion Inequalities in IMR seem to have decreased due to a steeper reduction in both neonatal and post-neonatal components of infant mortality in lower maternal schooling area. ResumoObjetivo Determinar as tendências da mortalidade infantil de 1995 a 1999, segundo a escolaridade materna, medidas em base geográfica, em Porto Alegre, Brasil. Métodos Estudo baseado em dados secundários de um banco de dados municipal, criado em 1994. Todos os nascidos vivos (119.170 nascimentos) e óbitos infantis (1.934 óbitos) foram considerados. Foram definidas cinco diferentes áreas geográficas segundo os quintis de percentagem de escolaridade materna baixa (menos de seis anos de estudo): alta, médio-alta, média, média-baixa e baixa escolaridade. Foi usado o teste do qui-quadrado para tendências de comparação das taxas entre as áreas. Foi calculada a razão de incidências pela regressão de Poisson para identificar excesso 2002;36(4):478-83 www.fsp.usp.br/rsp4 7 9 4 7 9 4 7 9 4 7 9 4 7 9 Rev Saúde Pública Infant mortality in Southern BrazilGoldani MZ et al. de mortalidade infantil nas áreas mais pobres, em comparação com as mais ricas.

Neonatal mortality still remains a complex challenge to be addressed. In Brazil, 60% of neonatal deaths occur among preterm infants with a gestational age of 32 weeks or less (≤32w). The aim of this study was to evaluate the factors involved in the high mortality rates among newborns with a gestational age ≤32w in a socioeconomically developed southern city in Brazil. Data on retrospective births and deaths (2000-2014) were analyzed from two official Brazilian national databases. The risk of neonatal death for all independent variables (mother's age and schooling, prenatal visits, birth hospital, delivery method, gestational age, and the newborn's sex, age, and birth year, gemelarity, congenital anomalies and birthplace) was assessed with a univariable and a multivariable model of Cox's semiparametric proportional hazards regression (p < 0.05). Data of 288,904 newborns were included, being 4,514 with a gestational age ≤32w. The proportion of these early newborns remained stable among all births, while the neonatal mortality rate for this group tended to decrease (p < 0.001). The adjusted risk was significantly for lower birthweight infants (mean 659.13 g) born from Caesarean (HR 0.58 [95% CI 0.47-0.71]), but it was significantly higher for heavier birth weight infants (mean 2,087.79) also born via Caesarean section (HR 3.71 [95% CI 1.5-9.15]). Newborns with lower weight seemed to benefit most from Cesarean deliveries. Effort towards reducing unacceptably high surgical deliveries must take into account cases that the operations may be lifesaving for mother and/or the baby. The reduction in infant mortality rates over the past few years has enabled Brazil to attain the fourth goal of the eight Millennium Development Goals proposed by the United Nations: to reduce infant mortality by two-thirds between 1990 and 2015 1. However, unlike postneonatal mortality, neonatal mortality has not yet reached acceptable rates considering the country's technological and economic development. Neonatal mortality in Brazil still remains a complex challenge to be addressed 2. Most neonatal deaths occur among preterm newborns 3. In Brazil, 60% of neonatal deaths occur among preterm infants with a gestational age of 32 weeks or less 4. Of all neonatal deaths, 75% occurred between zero and six days of age, and one in four deaths occurred during the first 24 hours of life 1,5,6. Despite this scenario, there are few studies that seek to elucidate the causes or factors contributing to mortality in this population. This study investigated the possible contributing factors involved in the high mortality rates among newborns with a gestational age of up to 32 weeks at a socioeconomically developed capital city in southern Brazil. Data were obtained through the vital statistics published by two official health information systems combined by means of a record linkage in a time series. Methods Porto Alegre is the capital city of the state of Rio Grande do Sul, Brazil, with a population of 1,467,823 (2013) and a very high Human Development Index...