[Density equalizing mapping of obesity: analysis of a global epidemic]. / Density Equalizing Mapping der Adipositas: Analyse einer globalen Epidemie.

Obesity is a chronic disease whose origin is determined by genetic factors as well as environmental influences. The prevalence has rapidly increased worldwide in the recent decades. This paper evaluated the research on obesity in the period of 1900 - 2009 in the ISI "Web of Science" by Thomson Reuters. For this purpose scientometric methods were used and the results were graphically illustrated by "Density Equalizing Map Projections". From 1900 till 2009 94.987 published items are the basis for the present qualitative and quantitative data analysis. The publication rates show an exponential growth indicating a pronounced research activity. Concerning the country comparison the United States has the highest number of publications and citations, the highest modified h-index and most academic institutions. This manuscript shows the first comprehensive scientometric data on obesity. In this research area, the United States is a leader and is located at the center of global collaborations.

Topografia do cone medular da irara (Eira barbara) e sua relevância em anestesias epidurais / Topography of the conus medullari in tayra (Eira barbara) and their relevance in epidural anesthesia

Encontrada principalmente na América do Sul, a irara é um carnívoro pertencente à família Mustelidae, a qual pouco se tem informações sobre sua morfologia de forma geral. Diante disso, objetivou-se conhecer melhor parte do sistema nervoso desta espécie, mais precisamente a topografia do cone medular, a fim de subsidiar intervenções anestésicas peridurais nesta, uma vez que a clínica de animais selvagens vem crescendo a cada dia. Foram estudados três exemplares machos, adultos, provenientes da área de Mina Bauxita, Paragominas, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA), Universidade Federal Rural da Amazônia (UFRA), Belém, os quais foram radiografados e dissecados ao nível lombossacral, seguido de exposição do cone medular. Este, por sua vez, situou-se entre L4-L6 possuindo comprimento médio de 4,31cm, o que nos levou a sugerir a região sacrococcígea como ponde ideal para prática de anestesias epidurais nesta espécie.

Mainly found in South America, tayra is a carnivore belonging to the Mustelidae family, of which is little information regarding its morphology in general. The study aimed to characterize the topography of the medullar cone in order to subsidize epidural anesthetic interventions, since the clinics of wild animals is growing each day. We studied three adult male tayras from the Bauxite Mine area of Paragominas, donated to the Research Laboratory of Animal Morphology, Federal Rural University of Amazonia, Belém. They were x-rayed and dissected at the lumbosacral level to expose the medullar cone, which was found between L4-L6 with an average length of 4.31cm. This led us to suggest the sacrococcygeal region as ideal site for practice of epidural anesthesia in this species.

National trends in psychostimulant-related deaths: 1999-2009.

BACKGROUND: Increased methamphetamine use occurred during the last decade and little is known about factors associated with death. This study assesses trends in psychostimulant deaths in the United States. METHODS: Using the Centers for Disease Control and Prevention (CDC) Wonder Database, the authors searched deaths among 15- to 64-year-olds from 1999 to 2009 for decedents who died with "psychostimulants with abuse potential, excluding cocaine." The International Classification of Diseases (ICD) code T43.6 was used to identify methamphetamine-related deaths. Trends in death rates and the most common underlying causes of death were determined. For recent trends, age-adjusted death rates/100,000 person-years (p-y) and (95% confidence intervals [CIs]) among those who died with psychostimulants were calculated. RESULTS: The rate of psychostimulant-related deaths increased 3-fold from 1999 (0.37/100,000 p-y; 95% CI: 0.354-0.39) to 2005 (1.05/100,000 p-y; 95% CI: 1.01-1.10). Deaths steadily declined from 2006 to 2008, but rose again in 2009 to 0.97/100,000 p-y (95% CI: 0.92-1.01). Across all age groups, men had a 2 to 3 times higher rate of death than women. American Indians/Alaska Natives were twice as likely to die a psychostimulant-related death as compared with non-Hispanic whites. The northwestern/western region of the US had the highest rates of psychostimulant-related deaths, whereas the northeastern region had the lowest death rates. "Accidental poisonings" (ICD-10: X40-49) was the most frequently listed cause of death among those who died with psychostimulants. CONCLUSIONS: Psychostimulant-related deaths increased from 1999 to 2006, declined from 2006 to 2008, but rebounded in 2009. Interventions targeting those at highest risk of death must be implemented and studied to prevent increasing deaths.

Topografía médica de Lanjarón en la Real Academia de Medicina y Cirugía de Cádiz / Medical topography in Lanjaron in Royal Academy of Medicine and Surgery of Cadiz

La Real Academia de Medicina y Cirugía de Cádiz tiene su origen en la Sociedad Médica de Cádiz. El 30 de Septiembre de 1815 fue aprobado el Reglamento, sus Socios Fundadores fueron unos profesores del Real Colegio de Cirugía de la Armada. El estudio de las “Topografías médicas”, es un uso habitual en las Reales Academias de Medicina de España, desde que el “Reglamento general para el Régimen literario e interior de las Reales Academias de Medicina y Cirugía del Reino de 1830” lo impuso. Los Socios corresponsales de la Real Academia de Medicina y Cirugía de Cádiz tuvieron una destacada responsabilidad en las descripciones de las Topografías Médicas. El objetivo es el estudio de una memoria de la Real Academia de Medicina y Cirugía de Cádiz sobre una noticia topográfica de Lanjarón. El autor de la memoria hace una descripción de la situación topográfica de Lanjarón, de su clima en las distintas estaciones, del terreno, de las calles, del estado de salud y de las fuentes de aguas minerales medicinales destinadas al consumo oral y a los baños. Eduardo Mª González, académico corresponsal de la Real Academia de Medicina y Cirugía de Cádiz en Lanjarón cumple así con sus deberes de realizar la topografía médica de su país de residencia(AU)

The Royal Academy of Medicine and Surgery of Cadiz has its origin in the Medical Society of Cadiz. On September 30, 1815 was approved the Regulation, its founders were some teachers of the Royal College of Surgeons of the Navy. The study of "medical topographies" is a commonly used in the Royal Academy of Medicine in Spain, since the "General Regulations for the literary and internal arrangements of the Royal Schools ofMedicine and Surgery of the Kingdom of 1830" was imposed. Partners correspondents of the Royal Academy of Medicine and Surgery of Cadiz had a major responsibility in the descriptions of the Medical Topography. The aim is to study a report of the Royal Academy of Medicine and Surgery of Cadiz on a topographic Lanjarón news. The author of the report a description of the topographical situation of Lanjaron, its climate indifferent seasons, terrain, streets, health status and sources of medicinal mineral water intended fororal consumption and bathrooms. Eduardo M ª González, academic correspondent of the Royal Academy of Medicine and Surgery of Cadiz in Lanjarón thus fulfilling their duties to conduct the medical topography of their country of residence(AU)

[Identifying residential areas with heat-related health risks. Sociodemographic and climate data mapping as a planning tool for targeted prevention strategies]. / Wohngebiete mit hitzeabhängigen Gesundheitsrisiken ermitteln. Soziodemografische und klimatische Kartierung als Planungsinstrument gezielter Prävention.

Prognosticated heat waves in the context of climate change require appropriate strategies to prevent harmful health effects in the population. In a model project within the public health department of the Kassel region, elderly living in areas at risk of over-heating will be identified and advised. The localization of high-risk residential areas was part of the planning process. Through mapping of demographic and microclimate data and the characteristics of the material of the residential buildings, high-risk areas that require preventive measures as a top priority were identified. The prevention of heat-related mortality and morbidity by communal health authorities requires close cooperation with other administrative bodies, especially with town planning departments. Mapping demographic and microclimate data and the characteristics of the material of the residential buildings can facilitate the planning of preventive measures.

Spatial heterogeneity of malaria in Indian reserves of southwestern Amazonia, Brazil.

BACKGROUND: Malaria constitutes a major cause of morbidity in the Brazilian Amazon where an estimated 6 million people are considered at high risk of transmission. Indigenous peoples in the Amazon are particularly vulnerable to potentially epidemic disease such as malaria; notwithstanding, very little is known about the epidemiology of malaria in Indian reservations of the region. The aim of this paper is to present a spatial analysis of malaria cases over a four-year time period (2003-2006) among indigenous peoples of the Brazilian State of Rondônia, southwestern Amazon, by using passive morbidity data (results from Giemsa-stained thick blood smears) gathered from the National Malaria Epidemiologic Surveillance System databank. RESULTS: A total of 4,160 cases of malaria were recorded in 14 Indian reserves in the State of Rondônia between 2003 and 2006. In six reservations no cases of malaria were reported in the period. Overall, P. vivax accounted for 76.18 of malaria cases reported in the indigenous population of Rondônia. The P. vivax/P. falciparum ratio for the period was 3.78. Two reserves accounted for over half of the cases reported for the total indigenous population in the period--Roosevelt and Pacaas Novas--with a total of 1,646 (39.57%) and 1,145 (27.52%) cases, respectively. Kernel mapping of malaria mean Annual Parasite Index--API according to indigenous reserves and environmental zones revealed a heterogeneous pattern of disease distribution, with one clear area of high risk of transmission comprising reservations of west Rondônia along the Guaporé-Madeira River basins, and another high risk area to the east, on the Roosevelt reserve. CONCLUSION: By means of kernel mapping, it was shown that malaria risk varies widely between Indian reserves and environmental zones defined on the basis of predominant ecologic characteristics and land use patterns observed in the southwestern Brazilian Amazon. The geographical approach in this paper helped to determine where the greatest needs lie for more intensively focused malaria control activities in Indian reserves in the region. It also provided a reference to assess the effectiveness of control measures that have been put in place by Brazilian public health authorities.

Spatial and temporal variability of the Glossina palpalis palpalis population in the Mbini focus (Equatorial Guinea).

BACKGROUND: Human African Trypanosomiasis is a vector-borne parasitic disease. The geographical distribution of the disease is linked to the spatial distribution of the tsetse fly. As part of a control campaign using traps, the spatial and temporal variability is analysed of the glossina populations present in the Mbini sleeping sickness foci (Equatorial Guinea). RESULTS: A significant drop in the annual mean of the G. p. palpalis apparent density was noted from 2004 to 2005, although seasonal differences were not observed. The apparent density (AD) of G. p. palpalis varies significantly from one biotope to another. The fish dryers turned out to be zones with the greatest vector density, although the AD of G. p. palpalis fell significantly in all locations from 2004 to 2005. CONCLUSION: Despite the tsetse fly density being relatively low in fish dryers and jetties, the population working in those zones would be more exposed to infection. The mono-pyramidal traps in the Mbini focus have been proven to be a useful tool to control G. p. palpalis, even though the activity on the banks of the River Wele needs to be intensified. The application of spatial analysis techniques and geographical information systems are very useful tools to discriminate zones with high and low apparent density of G. p. palpalis, probably associated with different potential risk of sleeping sickness transmission.

[A process and the prospects for the medical geographic study].

Medical geography is an edge subject crossing many other subjects. It has lately become the focus of attention for the continuously worsening of the living surroundings (earth environment) of the human beings and a series of threats it imposes on human health. This text consists of a comprehensive description of the history of medical geography, a detailed introduction of the research work done in China. What's more, we put forward the idea that disease geography and health geography will become the hotspot in recent study in our country.

Geografía y salud en América Latina: evolución y tendencias / Gepgraphic and health in Latin America

Esfuerzos aislados e inconstantes han caracterizado la articulación secularmente reconocida entre la geografía y la salud humana. En la última década se ha renovado el interés internacional por el estudio de estas relaciones, tanto en el ámbito académico, como en la gerencia del sector salud. El presente trabajo explora la situación latinoamericana, y los avances y limitaciones en diferentes países del área. Trata la evolución de la geografía de la salud, las formas en que el arsenal teórico y metodológico de la geografía ha sido incorporado en el análisis de la distribución de enfermedades, muertes y otros daños, o como soporte para la distribución y organización de acciones para la atención médica, la prevención y la promoción de salud. Se destaca el impacto positivo del empleo progresivo de los análisis espaciales en salud pública, así como la pertinencia de una prudente y cuidadosa evaluación de sus resultados. A partir de reflexiones sobre abordajes geográficos de la salud-enfermedad, vigentes y perspectivos, se elabora un cuadro síntesis que expone líneas y temas prioritarios que se abordan en varios países latinoamericanos –aunque en general, de forma no sistémica(AU)

Geografía y salud en Cuba: tendencias y prioridades / Geography and health in Cuba: trends and priorities

Las relaciones y aportes de la geografía a las ciencias de la salud, han sido poco explorados en nuestro país. Es propósito de este trabajo reflexionar acerca de esos vínculos, a partir de presupuestos teóricos y metodológicos, así como de los principales componentes que los sustentan. Se exponen consideraciones sobre el significado de la heterogeneidad de la base territorial del sistema de salud en el país, las limitaciones del uso de escalas, niveles y unidades territoriales para la medición de los problemas de salud, y se debate en torno a las potencialidades para un mayor acercamiento a los espacios geográficos, como “lugares” de producción de daños a la salud. Se trata la necesidad de acciones que faciliten la conciliación entre las diferentes fuentes de información territorial y las unidades de estas, para lograr análisis más rigurosos y pertinentes. Se le otorga una atención particular al uso progresivo de mapas en el sector salud, y a la discusión sobre requerimientos mínimos del uso de técnicas cartográficas aplicadas a la gestión en salud, o a la interpretación de la desigual distribución de problemas de salud. Se exponen ejemplos que ilustran las principales direcciones de trabajo actual, y los avances en la introducción de recursos teóricos y metodológicos de la geografía en el sector salud(AU)

Geografía y salud en América Latina: evolución y tendencias

Esfuerzos aislados e inconstantes han caracterizado la articulaciónsecularmente reconocida entre la geografía y la salud humana. En la última década se ha renovado el interés internacional por el estudio de estas relaciones, tanto en el ámbitoacadémico, como en la gerencia del sector salud. El presente trabajo explora la situación latinoamericana, y los avances y limitaciones en diferentes países del área. Trata la evolución de la geografía de la salud, las formas en que el arsenal teórico y metodológicode la geografía ha sido incorporado en el análisis de la distribución de enfermedades, muertes y otros daños, o como soporte para la distribución y organización de acciones para la atención médica, la prevención y la promoción de salud. Se destaca el impacto positivo del empleo progresivo de los análisis espaciales en salud pública, así como la pertinencia de una prudente y cuidadosa evaluación de sus resultados. A partir de reflexiones sobre abordajes geográficos de la salud-enfermedad, vigentes y perspectivos,se elabora un cuadro síntesis que expone líneas y temas prioritarios que se abordan en varios países latinoamericanos –aunque en general, de forma no sistémica.

Geografía y salud en Cuba: tendencias y prioridades / Geography and health in Cuba: trends and priorities

Las relaciones y aportes de la geografía a las ciencias de la salud, han sido poco explorados en nuestro país. Es propósito de este trabajo reflexionar acerca de esos vínculos, a partir de presupuestos teóricos y metodológicos, así como de los principales componentes que los sustentan. Se exponen consideraciones sobre el significado de la heterogeneidad de la base territorial del sistema de salud en el país, las limitaciones del uso de escalas, niveles y unidades territoriales para la medición de los problemas de salud, y se debate en torno a las potencialidades para un mayor acercamiento a los espacios geográficos, como “lugares” de producción de daños a la salud. Se trata la necesidad de acciones que faciliten la conciliación entre las diferentes fuentes de información territorial y las unidades de estas, para lograr análisis más rigurosos y pertinentes. Se le otorga una atención particular al uso progresivo de mapas en el sector salud, y a la discusión sobre requerimientos mínimos del uso de técnicas cartográficas aplicadas a la gestión en salud, o a la interpretación de la desigual distribución de problemas de salud. Se exponen ejemplos que ilustran las principales direcciones de trabajo actual, y los avances en la introducción de recursos teóricos y metodológicos de la geografía en el sector salud

Themes in British health geography at the end of the century: a review of published research 1998-2000.

This paper provides a succinct overview of some recent trends in geography of health in Britain since 1998. We consider how the research we have reviewed illuminates the relationships between geographies of health and three fundamental processes which are widely recognized as being important for contemporary human geography as a whole: globalization, urbanization and polarization. We also consider the contribution of health geography to agendas in cultural geography agenda which we refer to here as 'geographies of imagination'. These perspectives all relate to dynamic and diverse processes operating in Britain and throughout the world. We explore how health geography is responding to change, and what the agenda for future research will be. By considering these themes, we also seek to show how the geography of health is contributing to a wider discourse, shared to some extent in human geography as a whole, and we discuss the themes which are likely to feature in the future health geography research agenda.

[A cancer mortality atlas on a small geographic scale: procedure, validity and possibilities for its use]. / Erstellung eines kleinräumigen Krebsatlanten: Vorgehensweise, Validität und Nutzungsmöglichkeiten.

Cancer mortality in two counties (Dithmarschen and Nordfriesland) of the Federal State of Schleswig-Holstein (Germany) was assessed by analysing the death certificates for the period from 1980 to 1991. Age-adjusted cancer mortality rates were calculated for the more common cancers for counties as well as for smaller sub-scales. The procedure in respect of data base, data protection, data flow, calculation of rates and mapping of cancer mortality rates on small geographic scales is described and discussed. The data collected by us was compared with the data provided by the offices of statistic affairs on a county scale (only for the more common cancers). The comparison was done for each gender and each county, respectively. The agreement was high (> 95%) for 16 of 22 compared items, and below 90% for two items only. The validity of the data, therefore, was considered sufficient for epidemiological studies. As an example, results regarding female breast cancer rates are shown. The possibilities for the utilization of cancer registries on small geographic scales are discussed: Depending on the incidence of the occurrence of different cancers, cancer registries should provide data on multiple regional scales. A more flexible use of the possibilities of the assessment of regional cancer rates is imperative to utilise the very expensive and time-consuming instruments of analytical epidemiological studies of the causes of cancer more effectively.