ABSTRACT
Resumo Fundamentos As doenças isquêmicas do coração (DIC) são a primeira causa de mortes dentre as doenças cardiovasculares (DCV). Objetivo Descrever o perfil sociodemográfico e analisar tendência da taxa de mortalidade por DIC, segundo sexo e por faixa etária, nos estados da região Nordeste do Brasil, 1996-2016. Métodos Estudo ecológico envolvendo a mortalidade por DIC nos estados do Nordeste. Variáveis analisadas: sexo, idade, escolaridade, estado civil, categoria do CID-10 e estado de residências. Foram calculadas taxas brutas e padronizadas. Os dados de óbitos foram coletados do Sistema de Informações sobre Mortalidade; e os dados populacionais, do Instituto Brasileiro de Geografia e Estatística (IBGE). Nas análises temporais, utilizou-se o modelo de regressão por pontos de inflexão, com cálculo do percentual de variação anual (APC, Annual Percent Change) e do percentual de variação médio do período (AAPC, Average Annual Percent Change). Considerou-se intervalo de confiança de 95% e significância de 5%. Resultados Registrou-se 405.916 óbitos por DIC na região Nordeste durante o período estudado. O perfil de óbitos caracteriza-se por homens (n=229.006; 56,42%), idosos (n=301.379; 74,25%), raça/cor parda (n=197.936; 48,76%), fundamental ou <4 anos na escola (n=232.599; 57,30%) e casados (n=179.599; 44,25%). Houve destaque incomum para o aumento na taxa de incremento anual na faixa etária de adolescentes (AAPC: 5,2%, p<0,01). A taxa de mortalidade regional padronizada cresceu de 30,7/100 mil habitantes, em 1996, para 53,8/100 mil, em 2016 (AAPC:2,8%; p<0,01). Todos os nove estados apresentaram tendência estatisticamente significante de crescimento, com ênfases para o Maranhão (AAPC:7,6%; p<0,01) e o Piauí (AAPC:6,0%; p<0,01). Conclusão O perfil prevalente observado foi de homens, idosos, raça/cor parda, baixa escolaridade e casados. A mortalidade por DIC apresentou tendência de crescimento em todos os estados, ainda que com padrão desigual entre as unidades federadas.
Abstract Background Ischemic heart disease (IHD) is the leading cause of death among cardiovascular diseases (CVD). Objective To describe the sociodemographic profile and analyze the trend in the mortality rate due to IHD, according to sex and by age group, in the states of the Northeast region of Brazil, from 1996 to 2016. Methods Ecological study involving IHD mortality in the northeastern states. Variables analyzed: sex, age, education, marital status, ICD-10 category and state of residence. Crude and standardized rates were calculated. Death data were collected from the Mortality Information System (SIM) and population data from the Brazilian Institute of Geography and Statistics (IBGE). In temporal analyzes the regression model by inflection points was used, with the calculation of annual percent change (APC) and average annual percent change of the period (AAPC). A 95% confidence interval and a significance level of 5% were considered. Results 405916 deaths due to IHD were registered in the northeast region during the study period. The death profile is characterized by men (n=229006; 56,42%), elderly (n=301379; 74,25%), race/color brown (n=197936; 48,76%), elementary or <4 years at school (n=232599; 57,30%) and married (n=179599; 44,25%). There was an unusual highlight to the increase in the annual growth rate in the age group of adolescents (AAPC: 5,2%, p <0.01). The standardized regional mortality rate grew from 30,7 per 100,000 inhabitants in 1996 to 53.8 per 100,000 in 2016 (AAPC 2.8%; p<0.01). All nine states presented a statistically significant growth trend, with emphasis on Maranhão (AAPC 7,6%; p<0.01) and Piauí (AAPC 6,0%; p<0.01). Conclusion The prevalent observed profile was male, elderly, race/color brown, low education level and married. Mortality due to IHD presented an upward trend in all states, although with an uneven pattern among the federated units.
Subject(s)
Humans , Male , Adolescent , Adult , Cardiovascular Diseases , Myocardial Ischemia , Brazil/epidemiology , Mortality , Educational Status , GeographyABSTRACT
Abstract Introduction: The present study intends to systematically review the literature on the use of extracorporeal membrane oxygenation (ECMO) in patients with coronavirus disease 2019 (COVID-19). Methods: The research was carried out according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). Studies were selected from PubMed/MEDLINE and LILACS databases between December 2019 and May 17 2020, using the descriptors "ECMO AND COVID-19", "Extracorporeal Membrane Oxygenation AND COVID-19", "ECLS AND COVID-19", and "Extracorporeal Life Support AND COVID-19". Exclusion criteria were government epidemiological bulletins, comments, literature reviews, and articles without full access to content. Results: Two hundred and thirty-three scientific productions were found, however only 18 did not met the exclusion criteria and could be included in this study, amouting to a total of 911 patients - 624 (68.5%) men, 261 (28.6%) women, and 26 (2.8%) without sex information. The mean age of the patients was 53.7 years. ECMO was necessary in 274 (30.1%) people (200 [73%] submitted to veno-venous ECMO, nine [3.3%] to veno-arterial ECMO, and seven [2.5%] moved between these two types or needed a more specific ECMO according to the disease prognosis). Five studies did not specify the type of ECMO used, amounting 57 (20.8%) patients. Five patients (1.8%) were discharged, 77 (28.1%) died, 125 (45.6%) remained hospitalized until publication time of their respective studies, and 67 patients (24.4%) had no outcome information. Conclusion: It is evident that more research, covering larger populations, must be carried out in order to clearly elucidate the role of ECMO in the treatment of COVID-19.
Subject(s)
Extracorporeal Membrane Oxygenation , COVID-19 , Prognosis , SARS-CoV-2 , Middle AgedSubject(s)
Humans , Pneumonia, Viral/diagnosis , Coronavirus Infections/diagnosis , Betacoronavirus , Hospitalization/statistics & numerical data , Occupations/statistics & numerical data , Pneumonia, Viral/epidemiology , Coronavirus Infections , Coronavirus Infections/epidemiology , Pandemics , Occupations/classificationABSTRACT
Introdução: Desde o início da pandemia de Covid-19, estudos apontam que pacientes oncológicos representam um dos principais grupos de risco. Objetivo: Sintetizar a literatura no que se refere ao perfil clínico-epidemiológico de pacientes oncológicos com Covid-19. Método: Revisão integrativa da literatura a partir da base PubMed, utilizando os descritores COVID-19, SARS-CoV-2, 2019-nCoV, n-CoV e coronavirus combinados com cancer, tumor e malignancy. Resultados: Dos 821 artigos encontrados, nove textos foram incluídos na análise qualitativa, totalizando 39 indivíduos, com predomínio do sexo masculino (74,4% homens): China (6 textos, 35 pacientes), Nigéria (1 texto, 1 paciente), França (1 texto, 2 pacientes) e Dinamarca (1 texto, 1 paciente). Os cânceres de pulmão (51,3%; n=20) e de mama (10,3%; n=4) foram os mais prevalentes. Em 87,2% (n=34), não foram relatadas informações sobre hábitos de vida. Os sintomas respiratórios (46,8%; n=18) e febre (43,6%; n=17) se destacaram. Seis pacientes foram a óbito (15,4%), quatro receberam alta por cura (10,2%), dois permaneceram internados até a publicação do estudo (5,2%) e sobre os demais (69,3%, n=27) o manuscrito não informava o desfecho. Conclusão: O cuidado adequado a esse grupo especial de pacientes quando infectados pelo novo coronavírus é fundamental em busca de melhores desfechos. Mais estudos ainda são necessários para uma melhor compreensão de como a Covid-19 se comporta em pacientes com câncer.
Introduction: Since the beginning of COVID-19 pandemic, studies indicate that oncologic patients represent one of the main risk groups. Objective: To synthesize the literature addressing clinical and epidemiological profile of oncologic patients with COVID-19. Method: A systematic review of the literature was carried out in the PubMed database, utilizing the descriptors COVID-19, SARS-CoV-2, 2019-nCoV, n-CoV and coronavirus combined with cancer, tumor and malignancy. Results: Of the 821 articles found, nine texts were included in the qualitative analysis, totaling 39 individuals, predominantly male (74.4% men): China (6 texts, 35 patients), Nigeria (1 text, 1 patient), France (1 text, 2 patients), Denmark (1 text, 1 patient). Lung (51.3%; n=20) and breast (10.3%; n=4) cancers were the most prevalent. In 87.2% (n=34), information about life habits were not reported. Respiratory symptoms (46.8%; n=18) and fever (43.6%; n=17) stood out. Six patients died (15.4%), four were discharged due to cure (10.2%), two remained hospitalized until the study was published (5.2%) and for the other patients (69.3%, n=27), the manuscript did not inform the outcome . Conclusion: Adequate care for this special group of patients when infected with the new coronavirus is essential in pursuing better outcomes. Further studies are still needed to better understand how COVID-19 behaves in cancer patients.
Introducción: Desde el comienzo de la pandemia de Covid-19, los estudios indican que los pacientes con cáncer representan uno de los principales grupos de riesgo. Objetivo: Sintetizar la literatura sobre el perfil clínico-epidemiológico de pacientes con cáncer además de Covid-19. Método: Revisión integral de la literatura utilizando la base de datos PubMed, con los descriptores COVID-19, SARS-CoV-2, 2019-nCoV, n-CoV y coronavirus combinados con cáncer, tumor y malignidad. Resultados: De los 821 artículos encontrados, se incluyeron nueve textos en el análisis cualitativo, totalizando 39 individuos, predominantemente hombres (74.4% hombres): China (6 textos, 35 pacientes), Nigeria (1 texto, 1 paciente), Francia (1 texto, 2 pacientes), Dinamarca (1 texto, 1 paciente). Los cánceres de pulmón (51,3%; n=20) y de mama (10,3%; n=4) fueron los más prevalentes. En 87,2% (n=34) del total, no se informó ninguna información acerca de hábitos de vida. Se destacaron los síntomas respiratorios (46,8%; n=18) y fiebre (43,6%; n=17). Seis pacientes fallecieron (15,4%), cuatro fueron dados de alta por cura (10,2%), dos permanecieron hospitalizados hasta que se publicó el estudio (5,2%) y en los otros (69,3%, n=27) el manuscrito no informó el resultado. Conclusión: La atención adecuada para este grupo especial de pacientes cuando se infectan con el nuevo coronavirus es esencial en la búsqueda de mejores resultados. Todavía se necesitan más estudios para comprender mejor cómo se comporta Covid-19 en pacientes con cáncer.