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8%; 95% CI - 4.3; -3.3) than in other municipalities (-1.5%; 95% CI - 1.8; -1.3). Regional inequalities were observed, with an increase for men living in other municipalities of the North (3.3; 95% CI 1.3; 5.4) and Northeast (1.3%; 95% CI 1.0; 1.6). Statistical significance level was set at 5%. Mortality rates after corrections showed a significant difference in relation to the estimates without corrections, mainly due to the redistribution of garbage codes.
Although AMI-related mortality has decreased in Brazil in recent years, this trend is uneven by region and gender. Correcting the numbers of deaths is essential to obtaining more reliable estimates.
Although AMI-related mortality has decreased in Brazil in recent years, this trend is uneven by region and gender. Correcting the numbers of deaths is essential to obtaining more reliable estimates.
Neck circumference (NC), an indirect measure of upper-body subcutaneous adipose tissue, has been pointed out as an independent predictor of cardiometabolic diseases.
To assess the association between NC and 10-year cardiovascular risk in men and in women.
Cross-sectional analysis of 13,920 participants of the (baseline) Longitudinal Study of Adult Health (ELSA-Brasil). The association between NC (used as continuous variable and grouped into quartiles) and the 10-year cardiovascular risk was estimated by the Framingham Global Risk Score and analyzed by generalized linear models after adjustments for sociodemographic characteristics, health behaviors, body mass index and waist circumference. RG108 The significance level adopted was 5%.
Mean NC was 39.5 cm (SD± 3.6) in men and 34.0 cm (SD±2.9) in women. After adjustments, a one-centimeter increase in NC was associated with an increment of 3% (95%CI1.02-1.03) and 5% (95% 1.04-1.05) in the arithmetic mean of the 10-year CVD risk in men and women, respectively. link2 Men and women in the last quartile showed an increment of 18% (95%CI 1.13-1.24) and 35% (95%CI 1.28-1.43), respectively in the arithmetic mean of the 10-year CVD risk, after adjustments.
We found a positive, independent association between NC and the 10-year cardiovascular disease risk. NC may contribute to the prediction of cardiovascular risk, over and above traditional anthropometric measures.
We found a positive, independent association between NC and the 10-year cardiovascular disease risk. NC may contribute to the prediction of cardiovascular risk, over and above traditional anthropometric measures.
Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS).
To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study.
The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%.
This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most commoor with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5)830-839).
Acute pulmonary embolism (APE) has a variable clinical outcome. Computed tomography pulmonary angiography (CTPA) is the gold standard for this diagnosis.
To evaluate if the pulmonary vascular volume (PVV) quantified by automated software is a mortality predictor after APE.
Retrospective cohort study where the CTPA imaging of 61 patients with APE was reanalyzed. Pulmonary vascular volume (PVV) and pulmonary volume (PV) were automatically estimated using the Yacta software. We calculated the adjusted PVV by the ratio PVV(cm3)/PV(liters). Classical prognostic CTPA parameters (clot load index, right ventricle/left ventricle diameter ratio, pulmonary artery/aorta diameter ratio, ventricular septal bowing, pulmonary infarction and reflux of contrast into the hepatic vein) were assessed. The outcome assessed was one-month mortality. We considered a p-value <0.05 as statistically significant.
Seven deaths (11%) occurred at one month among these 61 patients. PVV<23cm3/L was an independent predictor of one-month mortality in the univariate [odds ratio (OR) 26; 95% confidence interval (CI) 3-244; p=0.004] and multivariate analyses [adjusted OR 19; 95%CI 1.3-270; p=0.03]. The classical CTPA parameters were not associated with one-month mortality in this sample. The PVV<23cm3/L showed a sensitivity of 86%, a specificity of 82%, a negative predictive value of 94% and a positive predictive value of 64% to identify the patients who died.
PVV<23cm3/L was an independent predictor of one-month mortality after APE. This parameter showed better prognostic performance than other classical CTPA findings. (Arq Bras Cardiol. link3 2020; 115(5)809-818).
PVV less then 23cm3/L was an independent predictor of one-month mortality after APE. This parameter showed better prognostic performance than other classical CTPA findings. (Arq Bras Cardiol. 2020; 115(5)809-818).
to describe the risk factors that influence the self-injury behavior of adolescents assisted at a Psychosocial Care Center for Children and Adolescents, according to subjects' own perceptions.
a descriptive, exploratory, qualitative study carried out through medical records and a focus group with 07 adolescents. The statements were submitted to thematic content analysis.
in the risk factors category, four subcategories emerged Family adversity factors; Social contagion; Adverse life events; Personal characteristics. Conflicts, lack of support, drug use in the family, meeting someone who cuts themselves, social networks, religiosity, history of sexual violence and bullying were identified as risk factors that influence self-injury.
adolescents pointed out the need for prejudice-free dialogues in schools, in health and family devices, configuring protective factors to avoid this practice that comes from several negative events throughout life.
adolescents pointed out the need for prejudice-free dialogues in schools, in health and family devices, configuring protective factors to avoid this practice that comes from several negative events throughout life.
to describe professionals' perceptions about the therapeutic effectiveness of group care.
a descriptive, exploratory, qualitative research of the type of intervention carried out with 30 professionals from Psychosocial Care Centers for Alcohol and Drugs in a municipality in center-westerns Brazil, from March to April 2019. Self-applicable instruments and round circles were used. The emerging data were submitted to content analysis.
professionals perceive the benefits of group practices and relate them to some therapeutic factors in the group. It is evident the little formal and systematized knowledge about the group process elements.
the therapeutic effectiveness of group processes is compromised due to absence of systematic records that allow to perceive the therapeutic progress of users, even though professionals perceive the emergence of therapeutic factors of the groups in the context of psychosocial care.
the therapeutic effectiveness of group processes is compromised due to absence of systematic records that allow to perceive the therapeutic progress of users, even though professionals perceive the emergence of therapeutic factors of the groups in the context of psychosocial care.
to apprehend the guidelines provided by the interdisciplinary team to the user's family member at a Centro de Atenção Psicossocial Álcool e Drogas (Psychosocial Care Center for Alcohol and Drugs).
descriptive-exploratory study, with a qualitative approach, carried out in a Psychosocial Care Center for alcohol and drugs in the southern region of Brazil, using the Psychiatric Reform as a conceptual basis. Data collection took place from June to August of 2019 through semi-structured interviews with a multidisciplinary team. The data were organized and operationalized in the IRAMUTEQ® software, and submitted to content analysis, thematic modality.
two classes emerged "Guidelines referring to moments of crisis and the family members' arrival to the service" and "Difficult factors and strategies to enhance the guidance to family members".
The guidelines focus on pathology and the service itself. Participants highlighted embracement, the group for families, qualified listening, and cooperation with primary care as ways to enhance the service to families.
The guidelines focus on pathology and the service itself. Participants highlighted embracement, the group for families, qualified listening, and cooperation with primary care as ways to enhance the service to families.
to estimate prevalence and factors associated with the consumption of psychoactive substances among health care workers in hospitals.
cross-sectional study, with a sample of 289 health care professionals in a large hospital in Teresina, Piauí, Brazil.
243 (84.1%) reported consumption of psychoactive substances; 124 (86.7%) of professionals who classed their level of satisfaction as moderate had double the chance (OR = 1.98 CI95% 1.02- 3.85) of consuming psychoactive substances; 40 (93%) of those with low level of satisfaction showed a four times higher chance (OR = 4.05 CI95% 1.15-14.26) of consumption; and 72 (75.8%) of those who reported a "good" state of health before work had a 54% lower chance of consumption (OR= 0.46 CI95% 0.234-0919).
consumption of psychoactive substances was associated with factors related to level of job satisfaction and perceived health status before work.
consumption of psychoactive substances was associated with factors related to level of job satisfaction and perceived health status before work.We report the clinical case of an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with gastrointestinal signs and symptoms, predominantly vomiting. The patient also had colic, poor feeding, mild diarrhea and mild rhinorrhea without fever. The child had evidence of altered coagulation, increased interleukin 10, moderate dehydration and she was admitted to the pediatric intensive care unit. Simultaneously, the patient was diagnosed as Clostridioides difficile infection, which possibly may have facilitated the persistence of SARS-CoV-2 in feces, for more than 27 days, even after the nasopharyngeal test turned negative. This coinfection might exacerbate the gastrointestinal signs and symptoms and increased the possibility of fecal-oral transmission of SARS-CoV-2 and Clostridioides . The patient was breastfed and received complementary infant formula, hydrated with intravenous fluid, and was discharged without complications, 4 days after admission.
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