BackgroundHotspot detection and characterization has played an increasing role in understanding the maintenance and transmission of zoonotic pathogens. Identifying the specific environmental factors (or their correlates) that influence reservoir host abundance help increase understanding of how pathogens are maintained in natural systems and are crucial to identifying disease risk. However, most recent studies are performed at macro-scale and describe broad temporal patterns of population abundances. Few have been conducted at a microscale over short time periods that better capture the dynamical patterns of key populations. These finer resolution studies may better define the likelihood of local pathogen persistence. This study characterizes the landscape distribution and spatio-temporal dynamics of Oligoryzomys fulvescens (O. fulvescens), an important mammalian reservoir in Central America.MethodsInformation collected in a longitudinal study of rodent populations in the community of Agua Buena in Tonosí, Panama, between April 2006 and December 2009 was analyzed using non-spatial analyses (box plots) and explicit spatial statistical tests (correlograms, SADIE and LISA). A 90 node grid was built (raster format) to design a base map. The area between the nodes was 0.09 km2 and the total study area was 6.43 km2 (2.39 x 2.69 km). The temporal assessment dataset was divided into four periods for each year studied: the dry season, rainy season, and two months-long transitions between seasons (the months of April and December).ResultsThere were heterogeneous patterns in the population densities and degrees of dispersion of O. fulvescens that varied across seasons and among years. The species typically was locally absent during the late transitional months of the season, and re-established locally in subsequent years. These populations re-occurred in the same area during the first three years but subsequently re-established further south in the final year of the study. Spatial autocorrelation analyses indicated local populations encompassed approximately 300–600 m. The borders between suitable and unsuitable habitats were sharply demarcated over short distances.ConclusionOligoryzomys fulvescens showed a well-defined spatial pattern that evolved over time, and led to a pattern of changing aggregation. Thus, hot spots of abundance showed a general shifting pattern that helps explain the intermittent risk from pathogens transmitted by this species. This variation was associated with seasonality, as well as anthropogenic pressures that occurred with agricultural activities. These factors help define the characteristics of the occurrence, timing, intensity and duration of synanthropic populations affected by human populations and, consequently, possible exposure that local human populations experience.

INTRODUCTION Climate variability, the primary expression of climate change, is one of the most important environmental problems affecting human health, particularly vector-borne diseases. Despite research efforts worldwide, there are few studies addressing the use of information on climate variability for prevention and early warning of vector-borne infectious diseases.OBJECTIVE Show the utility of climate information for vector surveillance by developing spatial models using an entomological indicator and information on predicted climate variability in Cuba to provide early warning of danger of increased risk of dengue transmission.METHOD An ecological study was carried out using retrospective and prospective analyses of time series combined with spatial statistics. Several entomological and climatic indicators were considered using complex Bultó indices -1 and -2. Moran's I spatial autocorrelation coeffi cient specifi ed for a matrix of neighbors with a radius of 20 km, was used to identify the spatial structure. Spatial structure simulation was based on simultaneous autoregressive and conditional autore-gressive models; agreement between predicted and observed values for number of Aedes aegypti foci was determined by the concordance index D i and skill factor B i .RESULTS Spatial and temporal distributions of populations of Aedes aegypti were obtained. Models for describing, simulating and predicting spatial patterns of Aedes aegypti populations associated with climate variability patterns were put forward. The ranges of climate variability affecting Aedes aegypti populations were identifi ed. Forecast maps were generated for the municipal level.CONCLUSIONS Using the Bultó indices of climate variability, it is possible to construct spatial models for predicting increased Aedes aegypti populations in Cuba. At 20 x 20 km resolution, the models are able to provide warning of potential changes in vector populations in rainy and dry seasons and by month, thus demonstrating the usefulness of climate information for epidemiological surveillance.

Estenose da artéria subclávia ocorre em aproximadamente 3% da população com doença aterosclerótica. O maior fator preditivo de sua ocorrência é a presença de doença vascular periférica, e os sintomas podem ser bastante limitantes. A terapêutica percutânea tem se constituído no tratamento de eleição para estes casos, e com o advento dos stents tornou-se um método eficaz, seguro e com altas taxas de sucesso. Um homem de 54 anos com passado de cirurgia de revascularização miocárdica (CRM) pontes de safena para ramos marginal (Mg) e diagonal (Dg) e implante de arté-ria mamária interna esquerda (MIE) para artéria descendente anterior (ADA), hipertensão arterial sistêmica, dislipidemia, tabagismo e doença vascular periférica foi internado por angina classe IV. No exame físico apresentava diminuição de pulsos em membros inferiores e diferencial de pressão de 20mmHg nos membros superiores. O eletrocardiograma mostrava isquemia subendocárdica em parede anterior. A cineangiocoronariografia mostrou oclusão do sisteRogério Sarmento-Leite, Luis Maria Yordi, Gilberto Heineck, Paulo Ortiz Jr., Carlos A. M. Gottschall Porto Alegre, RS Fig. 1 -Angiografia em projeção ântero-posterior da artéria subclávia esquerda, evidenciando uma estenose severa no terço proximal antes da emergência da artéria mamária interna esquerda. ma coronariano nativo esquerdo. A MIE para ADA, e a safena para o ramo Mg encontravam-se pérvias; a safena para o ramo Dg estava ocluída e havia uma estenose ulcerada severa na porção proximal da artéria subclávia esquerda, antes da emergência da MIE ( fig. 1). Realizou-se angioplastia com implante de stent periférico Jostent (Jomed, Rangendingen, Alemanha) 6-12 X 38mm, expandido com balão Fox 10 x 40mm (Jomed, Beringen, Suíça) com 8 atmosferas de pressão com excelente resultado angiográfico final ( fig. 2). Observou-se desaparecimento do gradiente de pressão entre os membros superiores e resolução dos sintomas do paciente. Estas imagens ilustram uma manifestação relativamente incomum, que deve necessariamente ser sempre lembrada, de sintomas anginosos limitantes e de fácil tratamento. Isto também reforça a importância de uma avaliação angiográfica das artérias subclávias antes de ser(em) utilizado(s) implante(s) de mamária quando uma CRM é planejada.

How to citeComplete issue More information about this article Journal's homepage in redalyc.org Scientific Information System Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Non-profit academic project, developed under the open access initiative

Interview MEDICC Review: You both have worked for over a decade on climate change and health-conducting research, designing national programs and implementing policies. Can you give us an overview of the work done in Cuba to date on the issue?Paulo Ortiz: First, let me say that Cuba has taken a different approach from many others around the world. Elsewhere, climate change is the subject of intense scientifi c study, but often little research is dedicated to the intersection of climate change and health. From the start, Cuba has studied the link between climate variability and its potential adverse effects on population health-specifi cally health problems particular to our context. The fi rst study we undertook in the 1990s examined climate change projections and the impact on infectious diseases: chicken pox, hepatitis and meningococcal disease, primarily. At that time, we consulted with a group of experts from the USA; we discussed methodology, diseases specifi c to the Caribbean region, and we debated Cuba's priorities, which at the time did not include vector-borne diseases as a serious health problem. Our second study, later in the nineties, focused on climate change and diseases transmitted by vectors.Since then, the Ministry of Public Health (MINSAP) has prioritized research into climate change and health and provided the political will and guidance to take an intersectoral, interministerial approach to the problem. Centers collaborating on current studies include the Pedro Kourí Tropical Medicine Institute, CLAMED (its work now merged into the National School of Public Health), the Cuban Red Cross, MINSAP itself, and the Ministry of Science, Technology and the Environment (CITMA), through CENCLIM. Organizing our work through this consortium of interdisciplinary research centers gives us new tools and approaches for how to mitigate and adapt to climate change. For instance, CITMA is responsible for setting priorities and designing policies for environmental protection. Concurrently, MINSAP sets priorities and designs policies for protecting and improving health-the intersection of climate change and health means these ministries must work together.