Epidemiology of hydrocephalus in Brazil

Abstract Objective Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS). Methods This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs. Results In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars. Conclusions Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.

Nem tudo que parece ser, é lesão: aspectos anatômicos, não lesões, artefatos, lesões sem significado clínico e alterações post mortem encontrados na necropsia de suínos domésticos e selvagens (Sus scrofa) / Not everything is an important lesion: anatomical structures, non-lesions, artifacts, lesions without clinical significance, and postmortem findings in domestic and feral pigs (Sus scrofa)

A interpretação das alterações encontradas na necropsia é uma etapa importante para o sucesso do diagnóstico final. Este trabalho tem como objetivo descrever e ilustrar os aspectos anatômicos, não lesões, artefatos, lesões sem significado clínico e alterações post mortem encontradas em suínos domésticos e selvagens. Além disso, também se recomenda técnicas de colheita de tecidos para o diagnóstico de doenças que acometem essa espécie. Os principais aspectos anatômicos e não lesões descritos são fímbrias linguais, quadrilátero esofágico, toro pilórico e demarcação do padrão lobular do fígado (sistema gastrintestinal); tonsilas do palato mole, tecido linfoide associado ao estômago, placas de Peyer do intestino delgado e dobras da margem do baço (sistema hematopoiético); mediastino proeminente do testículo e aréolas da placenta (sistema reprodutor); atelectasia pulmonar e apêndice decidual (feto); e glândulas carpais (sistema tegumentar). Os artefatos de eutanásia abordados são petéquias na superfície do pulmão e rim, falsa anemia por sangria, hemorragia subdural por concussão cerebral, pseudo-infartos do baço e aspecto cerebriforme do intestino delgado. As lesões de pouco significado clínico descritas são cistos renais, linfonodos com pigmento de ferro, papilomas e hemangiomas no escroto, ossos no mesentério e hiperemia da mucosa gástrica. As alterações post mortem comumente encontradas são livor mortis, músculos pálidos, pseudomelanose e líquido serosanguinolento nas cavidades torácica e abdominal em fetos.

The interpretation of the changes observed at necropsy is an important step for the success of the final diagnosis. This article aims to describe and illustrate the anatomical structures, non-lesions, artifacts, lesions without clinical significance and postmortem changes observed in domestic and wild pigs. Moreover, the article also recommends collection techniques of organs or structures for the diagnosis of diseases affecting this species. The main anatomical structures and non-lesions described are marginal lingual papillae, pars oesophagea of the stomach, torus pyloricus, and well demarcated lobular pattern of the liver (gastrointestinal system); tonsils of the soft palate, gastric lymphoid tissue, Peyer's patches of the small intestine, marginal folds of the spleen (hematopoietic system); prominent mediastinum testis and placental areolae (reproductive system); pulmonary atelectasis and periople (fetus); and carpal glands (integumentary system). The discussed artifacts related to euthanasia are petechiae on the surface of the lung and kidney, false anemia due to exsanguination, subdural hemorrhage due to cerebral concussion, pseudoinfarcts of the spleen, and cerebriform appearance of the small intestine. Lesions without clinical significance described are renal cysts, lymph nodes with iron pigment, papillomas and hemangiomas on the scrotum, osseous metaplasia in the mesentery, and hyperemia of the gastric mucosa. Commonly found postmortem changes are livor mortis, pale muscles, pseudomelanosis, and serosanguinous fluid in the thoracic and abdominal cavities of fetuses.

Simulaçäo da ejeçäo ventricular tipo "WINDKESSEL" com átrio ativo / Simulation of the \"WINDKESSEL\" ventricular ejection with active atrium

Este trabalho simula um modelo do batimento cardíaco, considerando a contração atrial no final da diástole e demonstra sua influência na ejeção ventricular. A circulação sistêmica é representada pelo modelo tipo "windkessel". A simulação foi desenvolvida num microcomputador IBM-PC compatível, utilizando-se da ferramenta de modelagem "bons graphs", através do programa de simulação Tutsim.