Os objetivos deste estudo são analisar o perfil de morbi-mortalidade em idosos hospitalizados em dois hospitais universitários e dois não universitários, da Área de planejamento 2.2 da cidade do Rio de Janeiro, Brasil, no ano de 1999, comparando as taxas de mortalidade hospitalar, ajustando para diferenças no perfil. Os dados foram obtidos do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS). O modelo logístico foi ajustado incluindo as variáveis idade e diagnóstico primário, utilizado para calcular as taxas de mortalidade hospitalar ajustadas. As internações hospitalares em idosos (n = 7.584) representaram 29,3% do total de 25.928 internações realizadas nessas unidades. Catarata senil (7,8%) foi a causa mais freqüente, seguida de hiperplasia de próstata (4,7%), insuficiência cardíaca congestiva (2,9%) e bloqueio atrioventricular total (2,8%). Os hospitais não universitários apresentaram taxas de mortalidade hospitalar maiores do que as dos hospitais universitários, mesmo depois do ajuste para diferenças no perfil de casos em relação à idade e diagnóstico principal. O uso dos bancos de dados do SIH/SUS e da metodologia de ajuste de risco representam uma alternativa para avaliações exploratórias de resultados de cuidados de saúde.

The study investigated IntroductionOral and pharyngeal cancer, grouped together, represent the sixth most common cancer in the world 1 . The annual estimated incidence is around 275,000 for oral and 130,300 for pharyngeal cancers excluding nasopharynx, with twothirds of these cases occurring in developing countries 1 . There is a wide geographical variation (approximately 20-fold) in the incidence of this cancer, and parts of Latin America and the Caribbean (including Brazil, Uruguay and Puerto Rico) are characterized by high incidence rates for oral cancer (excluding lip) 1 . In Brazil, excluding skin cancer, oral and pharynx cancer represent the fifth incidence of cancer in men and the seventh in women. The incidence rates ranged from 2.9/100,000 in Belém, Pará State (1996-1998) to 7.6/100,000 in São Paulo (1997)(1998) 2 . The most recent Brazilian National Cancer Institute (INCA) estimates for Rio de Janeiro State are 1,510 new cases for men and 520 for women 3 . Most are squamous cell carcinomas that develop after exposure to carcinogens such as tobacco and alcohol 4 . Oral and pharyngeal cancer involves complex causality, but available evidences suggest that environmental factors are driving the geographic patterns 5 .The role of diet in the etiology of oral and pharyngeal cancer remains unresolved. A recent revision concluded that consumption of non-starchy vegetables, fruits, and foods containing carote-ARTIGO ARTICLE

This study analyzed the reliability of the final diagnosis in the 155,242 dengue reports during the 2001-2002 epidemic in the city of Rio de Janeiro, Brazil, using the official information system on communicable diseases (SINAN). The system allows the following options for the final diagnosis: classic dengue, dengue hemorrhagic fever, discarded, inconclusive, and unknown. We built a classification routine in Epi Info to compare the final diagnosis from SINAN with Ministry of Health criteria. According to the final diagnosis, the case breakdown was: 52.4% classic dengue; 0.6% dengue hemorrhagic fever; 0.9% discarded; 46% inconclusive and unknown. The revised diagnosis showed that 78% of classic dengue, 69% of dengue hemorrhagic fever, and 21.1% of discarded cases met the classification criteria. Although the reliability of the SINAN final diagnosis was generally satisfactory (kappa = 0.681; 95%CI: 0.685-0.677), it was worse for fatal cases (kappa = 0.152; 95%CI: 0.046-0.258). Considering the epidemic's magnitude, the final diagnosis of classic dengue and dengue hemorrhagic fever was satisfactory, but the high proportion of inconclusive or unknown cases and the poor quality of information for fatal cases limit the usefulness of SINAN in this context.