ABSTRACT
Abstract Objectives: to analyze the epidemiological profile and the spatial-temporal dynamics on maternal mortality in Alagoas and its relationship with social vulnerability and income inequality. Methods: a mixed ecological study involving maternal deaths who resided in Alagoas from 1996 to 2016. Sociodemographic variables (age, race/color, education, marital status), clinical (type of obstetric cause, death by category and ICD group) were analyzed, besides the indicators (Maternal Mortality Ratio-MMR, Social Vulnerability Index and Gini Index). For the temporal analysis, we used the inflection point regression model and for the spatial analysis, the local empirical Bayesian model, Moran Global and Local statistics, and the bivariate local spatial autocorrelation analysis. Results: a total of 586 deaths (47.63/100 thousand live births) were registered, with a trend of MMR growth (APC 2.8%), with a heterogeneous distribution between health regions and cities. The profile was characterized by the predominance of young, black / mixed skin color women with low schooling. Eight cities were considered priority. There was spatial correlation with the Social Vulnerability Index and income inequality. Conclusions: identifying priority areas may contribute to planning and targeting interventions.
Resumo Objetivos: analisar o perfil epidemiológico e a dinâmica espaço-temporal da mortalidade materna em Alagoas e sua relação com a vulnerabilidade social e a desigualdade de renda. Métodos: estudo ecológico misto envolvendo os óbitos maternos de residentes em Alagoas de 1996 a 2016. Foram analisadas variáveis sociodemográficas (faixa etária, raça/cor, escolaridade, estado civil), clínicas (tipo de causa obstétrica, óbito por categoria e grupo de CID), além de indicadores (Razão de Mortalidade Materna-RMM, Índice de Vulnerabilidade Social e Índice de Gini). Para a análise temporal utilizou-se o modelo de regressão por pontos de inflexão e para a análise espacial o modelo bayesiano empírico local, a estatística de Moran Global e Local e a análise de autocorrelação espacial local bivariável. Resultados: foram registrados 586 óbitos (47,63/100 mil nascidos vivos), com tendência de crescimento da RMM (APC 2,8%), com distribuição heterogênea entre as regiões de saúde e municípios. O perfil foi caracterizado pelo predomínio de mulheres jovens, pretas/pardas e de baixa escolaridade. Oito municípios foram considerados prioritários. Houve correlação espacial com o Índice de Vulnerabilidade Social e de desigualdade de renda. Conclusões: a identificação de áreas prioritárias pode contribuir para o planejamento e direcionamento de intervenções.
Subject(s)
Humans , Female , Pregnancy , Socioeconomic Factors , Health Profile , Maternal Mortality , Mortality , Brazil/epidemiology , Space-Time Clustering , Gini Coefficient/methodsABSTRACT
Abstract INTRODUCTION: The number of syphilis cases among pregnant women in Brazil has increased. This study aimed to analyze the temporal trend of syphilis indicators among pregnant women in Northeast Brazil. METHODS: A time-series study was performed. RESULTS: We observed an increase in the detection rate of syphilis among pregnant women, those aged 15-19 years, and those of brown ethnicity. A strong correlation was observed between the detection rate of syphilis and family health strategy coverage. CONCLUSIONS: Despite an increase in primary care coverage, The increase in cases of syphilis among pregnant women is still considered a challenge.
Subject(s)
Humans , Female , Pregnancy , Child , Adolescent , Adult , Young Adult , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , Syphilis/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Family Practice/statistics & numerical data , Spatio-Temporal AnalysisSubject(s)
Humans , Diagnostic Imaging/history , Tomography, X-Ray Computed/history , Radiologists , UruguayABSTRACT
RESUMEN Se presenta un caso de paciente que ingresa por cuadro sindromático de insuficiencia cardiaca cuya progresión lo trae a la consulta, no presentando ningún antecedente personal ni familiar de enfermedades cardíacas ni sistémicas que pudieran justificar la aparición de esta patología. El único dato positivo de valor es la psoriasis que tenía diagnosticado con una evolución de dos años hasta el momento del presente cuadro. Ante la falta de antecedentes y el descarte de una enfermedad coronaria que subyazca en la alteración de la motilidad ventricular, se llega a la conclusión que la miocardiopatía dilatada presente probablemente sea atribuida a la psoriasis.
ABSTRACT We present the case of a patient who is admitted due to syndromic case of heart failure, whose progression brings him to the consultation, with no personal or family history of cardiac or systemic diseases that could justify the appearance of this pathology. The only datum with positive value is a psoriasis that was diagnosed with an evolution of two years until the moment of the present case. Considering the lack of history and the discarding of a coronary disease that underlies the alteration of the ventricular motility, it is concluded that the present dilated cardiomyopathy is probably attributed to the psoriasis.