Mortalidade de professores no estado de Goiás: análise de série temporal / Mortality of teachers in the state of Goiás: a time serie analysis

Análise de perfil epidemiológico e a tendência da mortalidade de professores da educação básica e do ensino superior no Estado de Goiás, no período de 2008 a 2017. Método: série temporal, com dados do Sistema de Informações sobre Mortalidade. Para a análise da tendência da mortalidade utilizou-se modelos de regressão linear e considerou-se p<0,05. Resultados: foram levantados 2.439 óbitos, maior frequência de óbitos no sexo feminino, em indivíduos de cor branca e com idade entre 50 e 69 anos. Entre as mulheres, as neoplasias malignas foram as principais causas de óbito, enquanto entre os homens destacaram-se as doenças do aparelho circulatório. Identificou-se tendência temporal de aumento dos óbitos (0,134 para as neoplasias malignas, 0,132 para as doenças do aparelho circulatório, 0,252 para as causas externas e 0,212 para as doenças do aparelho respiratório). Considerando todas as causas de óbito o incremento foi de 0,040 (p<0,000). Conclusão: há aumento de mortalidade de professores por causas evitáveis

Objective: to analyze the epidemiologic profile and the trends in mortality of teachers from basic education and higher education professors in the state of Goiás, in the period from 2008 to 2017. Method: time series, with data from the Mortality Information System. In order to analyze the trend in mortality, a linear regression model was used, considering p<0.05. Results: 2,439 deaths were recorded, with higher frequency of deaths within female sex, white and aged from 50 to 69 years. Among the women, malignant neoplasms were the main causes of death, whilst among men, circulatory system diseases stood out. It was identified a temporal trend of increase in deaths (0.134 for malignant neoplasms, 0.132 for circulatory system diseases, 0.252 for external causes and 0.212 for respiratory system diseases). Considering all the causes of death, the increase was 0.040 (p<0.000). Conclusion: there is an increase in mortality of teachers and professors due to avoidable causes

Mortality from chronic respiratory disease in Brazil: time trend and forecasts / Mortalidade por doença respiratória crônica no Brasil: tendência temporal e projeções

ABSTRACT OBJECTIVE To analyze the time trend of monthly mortality rates from chronic respiratory diseases in Brazil from 1996 to 2017, with forecasts for 2022, besides analyzing the possibility of achieving the goal of the Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil (Strategic Action Plan to Tackle Chronic Noncommunicable Diseases in Brazil) from 2011 to 2022. METHODS This is an ecological study that uses data from Sistema de Informações sobre Mortalidade (SIM - Mortality Information System), Sistema de Informações Demográficas e Socioeconômicas (Demographic and Socioeconomic Information System) and Pesquisa Nacional por Amostra de Domicílios Contínua (PNAD Contínua - Continuous National Household Sample Survey). We established the age range between 30 and 69 years old and the evolution of the rates over time was made by autoregressive integrated moving average models in R statistical tool. RESULTS Premature mortality rates from chronic respiratory diseases are decreasing in Brazil as a whole, mostly in state capitals. There is also a trend to reach the Ministry of Health's goal in most of the country. For capitals that tend not to reach the goal, there is an association between mortality and social indicators, healthcare network and frequency of smoking. CONCLUSION This study intends to improve planning of the public health system for the control of chronic respiratory diseases.

RESUMO OBJETIVO Analisar a tendência temporal das taxas mensais de mortalidade por doenças respiratórias crônicas no Brasil de 1996 até 2017, com projeções para 2022, além de analisar a possibilidade de cumprimento da meta do Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil de 2011 até 2022. MÉTODOS Trata-se de estudo ecológico que utiliza dados do Sistema de Informações sobre Mortalidade, do Sistema de Informações Demográficas e Socioeconômicas e da Pesquisa Nacional por Amostra de Domicílios Contínua. O recorte etário foi estabelecido entre 30 e 69 anos e a evolução das taxas no tempo foi feita por meio de modelos autorregressivos integrados de média móvel em plataforma estatística R. RESULTADOS As taxas de mortalidade precoce por doenças respiratórias crônicas apresentam-se decrescentes no Brasil como um todo e na maior parte das capitais, assim como, há tendência a atingir a meta do Ministério da Saúde na maior parte do país. Para capitais que tendem a não atingir a meta, verifica-se associação entre mortalidade e indicadores sociais, rede assistencial de saúde e frequência do tabagismo. CONCLUSÃO Pretende-se que o estudo possibilite um melhor planejamento do sistema público de saúde para o controle das doenças respiratórias crônicas.

Correlaciones entre el test de velocidad en 4 metros y el test de caminata en 6 min en enfermos respiratorios crónicos / Correlations between the 4 meter speed test and the 6-minute walking test in chronic respiratory patients

Resumen La prueba de velocidad de marcha en 4 metros (T4M) es considerada sustituto de la caminata en 6 min (TC6M) en EPOC. Sin embargo, no ha sido bien investigada en otras enfermedades respiratorias. Durante un año estudiamos pacientes que concurrieron a nuestra Unidad para realizar el TC6M midiendo la velocidad alcanzada en 4 metros, 2 h previo a realizar el TC6M. De 162 pacientes 99 eran mujeres. La edad media fue de 65 años, peso de 73 kg, talla de 158 cm, IMC 29,4 kg/m2. 36% tenían fibrosis pulmonar idiopática, 17% EPOC, GOLD IV,11% EPOC, GOLD III, 12% apnea de sueño y 12% otras enfermedades. No hubo diferencia para los distintos diagnósticos en ambos tests. La distancia media en TC6Mfue 368,5 m la velocidad: 1,01 m/s en T4M.Hubo una correlación positiva significativa entre ambos test: alto rendimiento en T4M es equivalente a un alto rendimiento en el TC6M. Hubo correlación negativa con la edad y positiva con la estatura. Al año de seguimiento 16 pacientes habían fallecido, siendo estos los que habían obtenido los más bajos rendimientos en ambos tests (T4M: 0,69 m/s y 248,1 m en TC6M) La posibilidad de sobrevida cayó a 20% en aquellos individuos que alcanzaron una velocidad inferior a 0,69 m/s. Es posible sustituir el TC6M por el T4M en pacientes con diferentes patologías respiratoria, podemos predecir la muerte por cualquier causa si un sujeto camina a una velocidad ≤ 0,69 m/s, T4M es barato y fácil de realizar en atención primaria, sirviendo como evaluación de riesgo para referir a un centro más complejo.

4-Meter Gait Speed Test (4MGST) a frailty test, is considered a surrogate for the 6-Minute Walk Test (6MWT) in COPD. However, it has not been investigated in other respiratory conditions. Over a year, we studied patients attending our Unit for evaluation with 6MWT, measuring the speed they achieved walking 4 m, 2 h before performing 6MWT. 162 patients (99 women) were studied; series' mean values were: age 65 years-old; body weight, 73 kg; height, 158 cm and BMI, 29.4 kg/m2. 36% of them had idiopathic pulmonary fibrosis, 17% GOLD IV COPD, 11% GOLD III COPD, 12% pulmonary arterial hypertension, 12% obstructive apnea-hypopnea syndrome, and 12% other conditions. ANOVA showed no difference between diagnostic categories for both test. Average score in 6MWT was 368.5 m and 1.01 m/s in 4MGST. Pearson correlation coefficient revealed significant positive correlation between results of both tests: high score in 4MGST is equivalent to high score in 6MWT. There was negative correlation with age and positive correlation with height. At one year follow-up, 16 patients had died. They obtained significantly lower scores in both tests (4MGST: 0.69 m/s and 6MWT: 248.1 m) Survival chance fell to 20% for patients walking slower than 0.69 m/s. It is possible to replace TC6M with T4M in patients with different respiratory pathologies, we can predict death for any cause if a subject walked at ≤ speed at 0.69 m/s. T4M is cheap and easy to perform in primary care, serving as a risk assessment to refer to a more complex center.

Profile of deaths from respiratory diseases in the state of Rio Grande do Sul, from 2006 to 2015 / Perfil dos óbitos por doenças respiratórias no interior do Rio Grande do Sul, 2006 a 2015 / Perfil de muertes por enfermedades respiratorias en el interior de Rio Grande do Sul, 2006 a 2015

Background and objectives: Respiratory diseases affect all age groups and pose a high demand on health services. The present study aimed to analyze the profile of patients who have died from respiratory diseases, between 2006 and 2015, from the 9th Health Coordination of Rio Grande do Sul. Methods: This is a cross-sectional and descriptive study using the database of the Informatics Department of the Unified Health System (Datasus) from the Ministry of Health in Brazil. Data collection was carried out in November 2017 and included 10 years up to 2015. The causes of death from respiratory disease were selected according to the International Classification of Diseases 10th revision, Chapter X, vital statistics, mortality from 1996 to 2015. The variables for this research were collected according to chronological distribution, gender, age and period of the year. Results: Out of a total of 1,471 deaths from respiratory diseases, 52% were men, most were older adults (61%) with up to 3 years of education (73.3%), which is possibly associated with low income. The main causes of death were chronic diseases of the lower airways and pneumonia, representing 56% and 29% of deaths, respectively. In addition, 34% of deaths occurred during winter. Conclusion: The main causes of mortality from respiratory diseases from the 9th Health Coordination were chronic diseases of the lower airways and pneumonia, with higher mortality rates in colder months, among older adults and patients with a lower level of education.(AU)

Justificativa e objetivos: As doenças respiratórias atingem todas as faixas etárias e geram grande demanda dos serviços de saúde. O presente estudo objetivou analisar o perfil dos óbitos por doenças respiratórias na 9ª Coordenadoria de Saúde do Rio Grande do Sul, entre 2006 e 2015. Métodos: Trata-se de um estudo transversal e descritivo em que se utilizou o banco de dados do Departamento de Informática do Sistema Único de Saúde (Datasus) do Ministério da Saúde do Brasil. A coleta de dados foi realizada em novembro de 2017, abrangendo os últimos 10 anos. A seleção das causas de óbitos por doenças respiratórias foi selecionada de acordo com o Código Internacional de Doenças 10ª revisão, Capítulo X, estatísticas vitais, mortalidade de 1996 a 2015. As variáveis para esta pesquisa foram coletadas de acordo com a distribuição cronológica, sexo, idade e período do ano do óbito. Resultados: Do total de 1.471 óbitos por doença respiratória, observou-se que 52% acometeram homens, na maioria idosos (61%) e com até 3 anos de estudo (73%), o que pressupõe baixa renda. As principais causas de óbitos foram as doenças crônicas das vias aéreas inferiores e pneumonia, equivalendo a 56% e 29% dos óbitos respectivamente, sendo 34% dos óbitos ocorridos durante o inverno. Conclusão: As principais causas de mortalidade por doenças respiratórias ocorridas na 9ª Coordenadoria de Saúde foram as doenças crônicas das vias aéreas inferiores e pneumonia, com maior ocorrência nos meses mais frios, acometendo mais homens idosos e com menor nível escolar.(AU)

Justificación y objetivos: Las enfermedades respiratorias afectan a todas las edades y generan gran demanda por los servicios de salud. El presente estudio objetiva analizar el perfil de las muertes por enfermedades respiratorias en la 9ª Coordinación de Salud del Rio Grande do Sul, entre 2006 y 2015. Métodos: Se trata de un estudio transversal descriptivo con base en informaciones del Departamento de Informática del Sistema Único de Salud (Datasus) del Ministerio de la Salud (Brasil). La recolección de datos se realizó en noviembre de 2017, abarcando los últimos 10 años. La selección de las causas de muertes por enfermedades respiratorias fue estimada seguido la Clasificación Internacional de Enfermedades 10ª Revisión, Capítulo X, estadísticas vitales, mortalidad de 1996 a 2015. Las variables para esta investigación fueron recolectadas de acuerdo con la distribución cronológica, sexo, edad y período del año del óbito. Resultados: De las 1.471 muertes por enfermedad respiratoria, fue observado que 52% en hombres (767), la mayoría ancianos (61%), hasta 3 años de estudio (73%,) o que presupone bajos ingresos. Las principales causas de muerte fueron las enfermedades crónicas de las vías aéreas inferiores y la neumonía, equivalente al 56% y 29% de los casos, respectivamente, el 34% de las muertes ocurrieron durante el invierno. Conclusiones: Las principales causas de mortalidad por enfermedades respiratorias ocurridas en la 9ª Coordinación de Salud en los 10 años fueron enfermedades crónicas de las vías aéreas inferiores y neumonía, con mayor ocurrencia en los meses más fríos, afectando más hombres ancianos con menor nivel escolar.(AU)

Seasonality of mortality under a changing climate: a time-series analysis of mortality in Japan between 1972 and 2015

BACKGROUND@#Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate.@*METHODS@#Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics.@*RESULTS@#The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27-1.30), 1.53 (95% CI: 1.50-1.55), and 1.46 (95% CI: 1.44-1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08-1.10), 1.10 (95% CI: 1.08-1.11), and 1.35 (95% CI: 1.32-1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54-1.42), 1.39% (95% CI: 0.82-1.97), and 0.13% (95% CI: - 1.24 to 1.48), respectively.@*CONCLUSION@#Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.

The role of absolute humidity in respiratory mortality in Guangzhou, a hot and wet city of South China

BACKGROUND@#For the reason that many studies have been inconclusive on the effect of humidity on respiratory disease, we examined the association between absolute humidity and respiratory disease mortality and quantified the mortality burden due to non-optimal absolute humidity in Guangzhou, China.@*METHODS@#Daily respiratory disease mortality including total 42,440 deaths from 1 February 2013 to 31 December 2018 and meteorological data of the same period in Guangzhou City were collected. The distributed lag non-linear model was used to determine the optimal absolute humidity of death and discuss their non-linear lagged effects. Attributable fraction and population attributable mortality were calculated based on the optimal absolute humidity, defined as the minimum mortality absolute humidity.@*RESULTS@#The association between absolute humidity and total respiratory disease mortality showed an M-shaped non-linear curve. In total, 21.57% (95% CI 14.20 ~ 27.75%) of respiratory disease mortality (9154 deaths) was attributable to non-optimum absolute humidity. The attributable fractions due to high absolute humidity were 13.49% (95% CI 9.56 ~ 16.98%), while mortality burden of low absolute humidity were 8.08% (95% CI 0.89 ~ 13.93%), respectively. Extreme dry and moist absolute humidity accounted for total respiratory disease mortality fraction of 0.87% (95% CI - 0.09 ~ 1.58%) and 0.91% (95% CI 0.25 ~ 1.39%), respectively. There was no significant gender and age difference in the burden of attributable risk due to absolute humidity.@*CONCLUSIONS@#Our study showed that both high and low absolute humidity are responsible for considerable respiratory disease mortality burden, the component attributed to the high absolute humidity effect is greater. Our results may have important implications for the development of public health measures to reduce respiratory disease mortality.

Heterogeneidade nas causas de morte da população idosa da região Nordeste do Brasil / Heterogeneity in the causes of death among older adults in Northeastern Brazil / Heterogeneidad en las causas de muerte de ancianos en el nordeste de Brasil

Este artigo ecológico propõe-se a analisar os diferenciais na escala de prioridades das causas de morte entre a população idosa do Nordeste do Brasil, no período de 2001 a 2015, conforme três grupos etários: 60 a 69 anos (sexagenários), 70 a 79 anos (septuagenários) e 80 anos ou mais (longevos). Foram utilizados os dados do Sistema de Informações sobre Mortalidade (SIM) e as causas de óbito foram analisadas descritivamente pela mortalidade proporcional. Sendo assim, registraram-se 2.461.383 óbitos, sendo a maior parte entre longevos (44,2%), no ambiente hospitalar (55,5%), entre homens (50,8%), de cor parda (49,0%), casados (37,1%) e sem nenhum ano de estudo (34,5%). As doenças cardiovasculares representaram a maior taxa de óbitos com mais de 30% em todos os grupos. Entre os sexagenários e septuagenários, a ordem de prioridades segue com as neoplasias, causas mal definidas, doenças endócrinas, metabólicas e nutricionais e doenças do aparelho respiratório. Já entre os longevos, a escala é seguida pelas causas mal definidas, doenças do aparelho respiratório, neoplasias e doenças endócrinas, metabólicas e nutricionais. Portanto, infere-se que os idosos longevos demandam uma atenção diferenciada dos outros idosos, sobretudo quanto à prevenção e ao tratamento das doenças respiratórias, bem como uma melhor determinação da causa básica nas declarações de óbito.

This ecological study analyzes the differences in the scale of priorities of causes of death among older adults in Northeastern Brazil, from 2001 and 2015, according to three age groups: 60 to 69 years (sexagenarian), 70 to 79 years (septuagenarian), and 80 years or older (old-old). Data were collected from the Brazilian Mortality Information System (SIM) and analyzed descriptively by proportional mortality. A total of 2,461,383 deaths were recorded, most were old-old adults (44.2%), who died in the hospital environment (55.5%), men (50.8%), brown (49.0%), married (37.1%) and illiterate (34.5%). Cardiovascular diseases accounted for the highest rate of death, with more than 30% in all groups. Among the sexagenarian and septuagenarian, the order of priorities follows with neoplasms, ill-defined causes, endocrine, metabolic and nutritional diseases, and respiratory diseases. Among the old-old, the scale is followed by ill-defined causes, respiratory diseases, neoplasms and endocrine, metabolic and nutritional diseases. This suggests that the old-old adults require specific attention from the other older population, especially regarding the prevention and treatment of respiratory diseases, as well as better determination of the underlying cause in death certificates.

Este estudio ecológico se propone analizar los diferenciales en la orden de prioridades de las causas de muerte en la población anciana del Nordeste de Brasil, en el período de 2001 a 2015, según tres grupos de edad: 60 a 69 años (sexagenarios), 70 a 79 años (septuagenarios) y 80 años o más de edad (longevos). A partir de datos del Sistema de Información sobre Mortalidad (SIM), las causas de muerte fueron analizadas descriptivamente por la mortalidad proporcional. Así se registraron 2.461.383 muertes, la mayoría en personas de 80 años o más (44,2%), en ambiente hospitalario (55,5%), entre hombres (50,8%), pardos (49,0%), casados (37,1%) y sin ningún año de estudio (34,5%). Las enfermedades cardiovasculares representan la mayor tasa de muertes, con más de 30% en todos los grupos. Entre los sexagenarios y septuagenarios, el orden de prioridades sigue con las neoplasias, causas mal definidas, enfermedades endocrinas, metabólicas y nutricionales, y enfermedades del aparato respiratorio. Ya en los longevos, la escala es seguida de las causas mal definidas, enfermedades del aparato respiratorio, neoplasias y enfermedades endocrinas, metabólicas y nutricionales. Por tanto, se observa que los ancianos longevos demandan una atención diferenciada que los otros ancianos, especialmente en cuanto a la prevención y tratamiento de las enfermedades respiratorias, así como una mejor determinación de la causa básica en las declaraciones de defunción.

Mortalidad infantil en la Cuenca Matanza Riachuelo. Comparación con la Ciudad de Buenos Aires, la provincia de Buenos Aires y la Argentina (de 2010 a 2017)Infant mortality in the Matanza-Riachuelo / River Basin. Comparison with the Autonomous City of Buenos Aires, the province of Buenos Aires, and Argentina (2010-2017)

Introducción. La tasa de mortalidad infantil (TMI) es un indicador de salud y de condiciones socioeconómicas, ambientales y sanitarias. Basurales a cielo abierto y desechos cloacales e industriales hacen de la Cuenca Matanza Riachuelo (CMR) la más contaminada de Argentina.Objetivo. Analizar la mortalidad infantil (MI) en la CMR en comparación con Argentina, provincia de Buenos Aires (PBA) y Ciudad Autónoma de Buenos Aires (CABA), y la evolución entre los años 2010 y 2017.Población y métodos. Estudio descriptivo a partir de datos del Ministerio de Salud de la Nación.Resultados. En 2017, la TMI en la CMR fue del 9,4 ‰; en Argentina, del 9,3 ‰; en PBA, del 9,4 ‰, y, en CABA, del 6,9 ‰. Entre 2010 y 2017, se observó una disminución de la TMI en la CMR del 20,6 %, similar a PBA y Argentina. En CABA, no hubo descenso.En las 4 jurisdicciones, las afecciones perinatales representaron la primera causa de muerte, seguidas por las malformaciones congénitas y las enfermedades respiratorias. Solo para enfermedad respiratoria, en la CMR, el riesgo fue 4 veces mayor que en CABA (riesgo relativo: 3,9; intervalo de confianza del 95 %: 1,4-10,7).Conclusión. La estructura de causas, la evolución y el riesgo de MI en la CMR, Argentina y PBA fueron similares entre 2010 y 2017. CABA presentó una TMI menor que CMR, pero no mostró descensos. El riesgo de MI en la CMR fue mayor que en CABA a expensas del mayor riesgo por enfermedad respiratori

Introduction. Infant mortality rate (IMR) is an indicator of health and socioeconomic, environmental, and health care conditions. Open dumps and sewage and industrial waste make the Matanza-Riachuelo River Basin the most polluted in Argentina.Objective. To analyze infant mortality (IM) in the Matanza-Riachuelo River Basin compared to Argentina, the province of Buenos Aires (PBA), and the Autonomous City of Buenos Aires (CABA), and its evolution between 2010 and 2017.Population and methods. Descriptive study based on data from Argentina's Ministry of Health.Results. In 2017, the IMR was 9.4 ‰ in the Matanza-Riachuelo River Basin; 9.3 ‰ in Argentina; 9.4 ‰ in PBA; and 6.9 ‰ in CABA. Between 2010 and 2017, the IMR in the Matanza-Riachuelo River Basin decreased by 20.6 %, similar to PBA and Argentina. No reduction was observed in CABA.In the 4 jurisdictions, perinatal conditions were the leading cause of death, followed by congenital malformations and respiratory diseases. For respiratory diseases only, the risk in the Matanza-Riachuelo River Basin was 4 times higher than in CABA (relative risk: 3.9; 95 % confidence interval: 1.4-10.7).Conclusion. The structure of causes, evolution, and risk of IM in the Matanza-Riachuelo River Basin, Argentina, and PBA was similar between 2010 and 2017. IMR was lower in CABA than in the Matanza-Riachuelo River Basin, but no reduction was observed in the former. The risk of IM was higher in the Matanza-Riachuelo River Basin than in CABA, at the expense of the increased risk of respiratory disease

Revisión de la bibliografía. Coronavirus (COVID-19) y Sistema Nervioso Central. Un panorama para analizar en una situación de pandemia. Consideraciones sobre el neurotrofismo del Coronavirus / Literature review. Coronavirus (COVID-19) and Nervous System Central. A panorama to analyze in a pandemic situation. Considerations on coronavirus neurotrophy

En humanos, las infecciones virales del tracto respiratorio son una causa principal de morbilidad y mortalidad en todo el mundo. Varios agentes virales respiratorios reconocidos tienen una capacidad neuroinvasiva, ya que pueden propagarse desde el tracto respiratorio hasta el sistema nervioso central (SNC). Una vez allí, la infección de las células del SNC (neurotropismo) podría conducir a problemas de salud humana, como encefalitis y enfermedades neurológicas a largo plazo. Los coronavirus (HCoV) generalmente infectan el tracto respiratorio superior, donde se asocian principalmente con resfriados comunes. Sin embargo, en las poblaciones más vulnerables, como los recién nacidos, los bebés, los ancianos y las personas inmunocomprometidas, también pueden afectar el tracto respiratorio inferior y provocar neumonía, exacerbaciones del asma, síndrome de dificultad respiratoria o incluso síndrome respiratorio agudo severo (SRAS) . Se ha establecido claramente la afectación respiratoria del VHC desde la década de 1960. Además, durante casi tres décadas, la literatura científica también ha demostrado que los HCoV son neuroinvasivos y neurotrópicos y podrían inducir una activación excesiva del sistema inmune.

In humans, viral infections of the respiratory tract are a leading cause of morbidity and mortality worldwide. Several recognized respiratory viral agents have a neuroinvasive capacity since they can spread from the respiratory tract to the central nervous system (CNS). Once there, infection of CNS cells (neurotropism) could lead to human health problems, such as encephalitis and long-term neurological diseases. Coronaviruses (HCoV) usually infect the upper respiratory tract, where they are mainly associated with common colds. However, in more vulnerable populations, such as newborns, infants, the elderly and immune-compromised individuals, can also affect the lower respiratory tract, leading to pneumonia, exacerbations of asthma, respiratory distress syndrome, or even severe acute respiratory syndrome (SARS). It has been clearly established the respiratory involvement of HCoV since the 1960s. In addition, for almost three decades now, the scientific literature has also demonstrated that HCoV are neuroinvasive and neurotropic and could induce an over activation of the immune system

Boletim Epidemiológico: mortalidade por doenças crônicas não-transmissíveis em Goiás, 2006 a 2016 / Epidemiological Bulletin: Mortality from non-communicable chronic diseases in Goiás, 2006 to 2016

As doenças crônicas não transmissíveis (DCNTs), como as doenças cardiovasculares, doenças respiratórias crônicas (bronquite, asma, DPOC, rinite), hipertensão, câncer e doenças metabólicas (obesidade, diabetes, dislipidemia), podem levar a incapacidades, ocasionando sofrimentos e custos materiais diretos aos pacientes e suas famílias, sem esquecer os custos intangíveis, como os efeitos adversos na qualidade de vida das pessoas afetadas. Produzem custos indiretos significativos para a sociedade e o governo em função da redução da produtividade, perda de dias trabalhados e prejuízos para o setor produtivo

Chronic non-communicable diseases (NCDs), such as cardiovascular diseases, chronic respiratory diseases (bronchitis, asthma, COPD, rhinitis), hypertension, cancer and metabolic diseases (obesity, diabetes, dyslipidemia), can lead to disabilities, causing suffering and costs. direct materials to patients and their families, without forgetting the intangible costs, such as adverse effects on the quality of life of those affected. They produce significant indirect costs for society and the government due to reduced productivity, lost days worked and losses for the productive sector

Mortalidad estandarizada según causas, edad y género en una comuna minera del norte de Chile entre 2006 y 2015 / Standardized mortality according to cauSe of death, age, and gender in a mining community in Northern Chile, 2006-2015

INTRODUCCIÓN: La comuna de Andacollo fue declarada Zona Saturada por material particulado en el año 2009, desconociéndose si dicha contaminación afecta la salud de sus habitantes o aumenta el riesgo de morir de su población. OBJETIVO: Comparar la mortalidad general y por causas cardiovasculares, respiratorias y neoplasias, según edad y género, de la comuna Andacollo con las tasas nacionales, entre 2006 y 2015. MATERIALES Y MÉTODOS: Con registros oficiales de defunciones y población, se calcularon tasas de mortalidad general, por causas específicas y según género. Se estandarizó con ajuste directo por edad las tasas comunales, para compararlas con las del país. RESULTADOS: Las tasas de mortalidad ajustadas de Andacollo tienden a ser, en promedio, 20% superiores a las nacionales, durante toda la década. Esta diferencia está dada principalmente por un mayor riesgo de morir en hombres, que es 35% mayor para neoplasias, 40% más para enfermedades cardiovasculares y 50% mayor para las enfermedades respiratorias. Estas diferencias de riesgo de morir es mucho menor para las mujeres (promedio 9%) y no se observan en la población joven (20-59 años). CONCLUSIONES: Las tasas de mortalidad general y específicas de Andacollo son significativamente superiores a las nacionales, pudiendo descartarse influencia de las condiciones ambientales en el riesgo de morir de su población, dada la heterogencidad presentada en los riesgos de morir por sexo. El exceso de riesgo de fallecer en hombres mayores podría explicarse por exposiciones laborales antiguas.

INTRODUCTION: The Chilean municipality of Andacollo was declared to be a Saturated Zone due to air pollution in 2009. It is unknown if this contamination affects the health of its inha-bitants. OBJECTIVE: To compare the general mortality and specific cardiovascular, respiratory, and neoplastic mortality rates in Andacollo with the national mortality rates between the years 2006 and 2015. MATERIALS AND METHODS: General and specific mortality rates, by gender, were calculated using official death and population registries. The Andacollo mortality rates were directly standardized by age and then compared with the national rates. RESULTS: The adjus-ted mortality rates of Andacollo tend to be, on average, 20% higher than the national ones, throughout the decade. This difference is mainly due to an increased risk of dying among men, which is 35% higher for cancers, 40% higher for cardiovascular diseases, and 50% higher for respiratory diseases. These differences in risk of dying are much lower for women (average 9%) and are not observed in the younger population (20-59 years of age). CONCLUSIONS: An-dacollo's general and specific mortality rates are significantly higher than national ones, and the influence of environmental conditions on the population's risk of dying can be ruled out, given the heterogeneity presented by sex. The excess risk of death among older men could be explained by previous occupational exposures.

Tendência e causa múltipla de óbito por insuficiência renal crônica em município da Amazônia brasileira / Trends and multiple causes of death due to chronic renal failure in a municipality in the Brazilian Amazon

Resumo O presente estudo buscou observar a tendência de mortalidade por insuficiência renal crônica (IRC) e verificar as causas básicas e associadas na capital do Acre, Amazônia brasileira. Para tanto, foi realizado um estudo ecológico com dados de óbitos por IRC do DATASUS ocorridos entre 1986 e 2012, em ambos os sexos de residentes em Rio Branco, Acre. Estimou-se a variação anual percentual (Estimated Annual Percentage Chance - EAPC) com a técnica de regressão log-linear de Poisson do programa Joinpoint. Os resultados demonstraram que as taxas de mortalidade ajustadas da IRC com correção variaram de 15,4 por 100.000 hab., em 1986, para 4,0 por 100.000 hab., em 2012. A EAPC foi de -3,5%, de 1986 a 2012. Os óbitos pela IRC apresentaram como causas associadas às doenças respiratórias, pneumonia e edema pulmonar, às septicemias e aos sinais e sintomas mal definidos. Quando analisada a IRC como causa associada, as principais causas básicas do óbito foram as doenças hipertensivas e o diabetes. Assim, houve redução da mortalidade por insuficiência renal crônica como causa básica no período observado, contudo medidas de prevenção e assistência em saúde devem ser mantidas.

Abstract This study examined the mortality trend due to chronic renal failure (CRF) and verified the underlying and associated causes for this trend in the capital of the state of Acre in the Brazilian Amazon. This ecological study used data provided by DATASUS related to mortality due to CRF, which occurred between 1986 and 2012 for male and female residents of the city of Rio Branco, Acre, Brazil. The estimated annual percentage chance (EAPC) was calculated by using Poisson log-linear regression and utilizing the Joinpoint program. The results showed that the adjusted mortality rates due to CRF, with correction, ranged from 15.4 per 100,000 inhabitants in 1986 to 4.0 per 100,000 inhabitants in 2012. The EAPC was -3.5% from 1986- 2012. Deaths by CRF presented associated causes such as respiratory diseases, pneumonia and pulmonary edema, septicemias and poorly defined signs and symptoms. When CRF was analyzed as an associated cause of death, the main primary causes of death were hypertensive diseases and diabetes. Thus, there was a decrease in mortality due to CRF as an underlying cause during the period studied; however, preventive and heath care measures should be maintained.

Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study / Mortalidade por doenças não transmissíveis no Brasil, 1990 a 2015, segundo estimativas do estudo de Carga Global de Doenças

ABSTRACT CONTEXT AND OBJECTIVE: Noncommunicable diseases (NCDs) are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD) 2015 study estimates for Brazil. DESIGN AND SETTING: Cross-sectional study covering Brazil and its 27 federal states. METHODS: This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths. RESULTS: This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years): ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS. CONCLUSION: The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025.

RESUMO CONTEXTO E OBJETIVO: As doenças crônicas não transmissíveis (DCNT) são o principal problema de saúde global e geram um elevado número de mortes prematuras e perda de qualidade de vida. O objetivo foi descrever os principais grupos de causas de morte por DCNT e o ranking das causas de morte prematura entre 1990 a 2015, segundo estimativas do estudo Global Burden of Disease (GBD) 2015 para o Brasil. TIPO DE ESTUDO E LOCAL: Estudo transversal do Brasil e 27 Unidades Federadas. MÉTODOS: Estudo descritivo das taxas de mortalidade por DCNT, com correções para sub-registro e códigos garbage. RESULTADOS: O estudo aponta a transição epidemiológica no Brasil entre 1990 e 2015, com o crescimento da mortalidade proporcional por DCNT, seguida das violências, e com a redução das causas maternas, infecciosas e infantis na carga global de doenças. As DCNT cursaram com as taxas de mortalidade mais elevadas em todo o período, mas com declínio para as doenças cardiovasculares, respiratórias crônicas e câncer. O diabetes aumentou no período. As DCNT lideram entre as causas de morte prematura (30 a 69 anos): doenças isquêmicas do coração e doenças cerebrovasculares, seguidas de violência interpessoal, lesão no trânsito e HIV/aids. CONCLUSÕES: A queda da mortalidade por DCNT confirma melhora do controle de doenças no país. Entretanto, a alta mortalidade por violência é um sinal de alerta. Mantendo-se a queda atual das DCNT, o Brasil deverá atingir as metas de redução propostas pela Organização Mundial de Saúde de 25% até 2025.

Redução de mortalidade em pacientes internados por doenças respiratórias após a implementação de unidade de cuidados intensivos em hospital secundário do interior do Brasil / Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil

RESUMOObjetivo:Avaliar relação entre a mortalidade intra-hospitalar de pacientes internados por doenças respiratórias e a disponibilidade de unidades de terapia intensiva.Métodos:Foi realizada coorte retrospectiva do banco de dados em um serviço de medicina hospitalar. Selecionaram- se pacientes internados por doenças respiratórias não terminais. Características clínicas, fatores de risco associado à mortalidade, como o escore de Charlson, e tempo de internação foram coletados. Foram realizados: análise univariada com estratificação simples por Mantel Haenszel, e testes qui quadrado, t de Student e Mann-Whitney, além de regressão logística.Resultados:Foram selecionados 313 pacientes, 98 (31,3%) antes da instalação da unidade de terapia intensiva e 215 (68,7%) após a disponibilização de unidade de terapia intensiva. Quando comparados quanto a características clínicas, antropométricas e fatores de risco, não houve diferença significativa. A mortalidade antes da disponibilidade da unidade de terapia intensiva foi de 18/95 (18,9%) e, após, de 21/206 (10,2%). Na regressão logística, a chance de morte após implantação da unidade de terapia intensiva diminuiu em 58% (OR: 0,42; IC95% 0,205 - 0,879; p = 0,021).Conclusão:Respeitando as limitações do estudo, conjetura-se benefício na redução de uma morte a cada 11 pacientes tratados por doenças respiratórias após a implantação da unidade de terapia intensiva no hospital. Estes resultados corroboram a impressão do benefício da implantação de unidades de terapia intensiva em hospitais de nível secundário.

ABSTRACTObjective:To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units.Methods:This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student’s t test, Mann-Whitney test, and logistic regression.Results:Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021).Conclusion:Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.

Cuantificación económica de los beneficios en salud asociados a la reducción de la contaminación por MP10 en Concepción Metropolitano, Chile / Health and economic benefits of reducing 10 µm particulate matter (PM10) in Metropolitan Area of Concepción, Chile

Background: Several international studies show the effects of PM10 pollution on health but specific analyses for many cities in Chile are lacking. Aim: To relate PM10 concentrations to effects with population health and quantify the economic benefits of its reduction in Concepción Metropolitan Area. Material and Methods: Poisson regression and generalized additive models were used to analyze the short-term effects of PM10 on mortality and morbidity, controlling for lags, seasonal, trend and weather variables. The damage function method to determine the economic impact of pollution reduction was used. Results: The selected concentration-response (C-R) coefficients showed that PM10 concentrations had effects on hospital admissions with a two days lag for respiratory diseases in children under 15 years of age and with a one day lag for asthma in patients over 64 years. The effects on premature mortality had a six days lag. The decrease in 1 µg/m³ of PM10 concentration would generate benefits ranging from 1,025.8 to 32,490.9 million of Chilean pesos per year, with a confidence level of 95%, according the estimation based on concentration-response coefficients and their economic cost. Conclusions: Reduction of PM10 would have important health and economic benefits.

Analysis of 105 Incarcerated Inmate's Death / 法医学杂志

OBJECTIVE@#To analyze the characteristics in the incarcerated inmate's death, investigate the main cause of death of the incarcerated inmate and provide some information for forensic investigation.@*METHODS@#The cases from the forensic medical center of Shanxi Medical University from 2005 to 2013 were selected. The statistical analysis was performed by using the incarcerated inmate's gender, age, cause of death, manner of death, and disease as the markers.@*RESULTS@#There were 100 men, 5 women in the 105 incarcerated inmates; the age range was from 16 to 65 years; Inmates were mostly died of natural diseases, mainly in the respiratory and cardiovascular diseases; the main unnatural death was suicide with a rate of 54.5%.@*CONCLUSION@#At present, most incarcerated inmate's death are due to natural diseases. The prison should improve incarcerated inmate's lives, work and health care conditions, and strengthen supervision of law enforcement.

Mortalidade por doenças crônicas não transmissíveis no Brasil e suas regiões, 2000 a 2011 / Chronic non-communicable disease mortality in Brazil and its regions, 2000-2011 / Mortalidad por enfermedades crónicas no transmisibles en Brasil y sus regiones, 2000 a 2011

Objetivo: descrever a mortalidade por doenças crônicas não transmissíveis (DCNT) no período 2000-2011 e as projeções do Plano de Enfrentamento das DCNT no Brasil para 2011-2022. Métodos: estudo descritivo das taxas de mortalidade por doenças do aparelho circulatório, câncer, diabetes e doenças respiratórias crônicas, com correções para causas mal definidas e sub-registro de óbitos informados. Resultados: houve um declínio médio de 2,5 por cento ao ano no conjunto das quatro principais DCNT no Brasil; houve declínio em todas as regiões; ocorreram quedas importantes, de 3,3 por cento para doenças cardiovasculares e de 4,4 por cento para doenças respiratórias crônicas, com menores declínios para o câncer, de 0,9 por cento, e para o diabetes, de 1,7 por cento. Conclusões: a redução de 2 por cento ao ano, já no primeiro ano do monitoramento, é positiva; espera-se, com a implementação das ações previstas no Plano de Enfrentamento das DCNT, e mantida queda como a observada na última década, que o Brasil cumpra a meta proposta...

Objective: to analyze non-communicable disease (NCDs) mortality trends from 2000 to 2011 and to provide mortality projections for use in evaluating Brazil’s Plan to Confront Chronic Non-Communicable Diseases, 2011-2022. Methods: analysis over time of mortality due to cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, with corrections for ill-defined causes and underreporting. Results: the mortality rate attributed to these 4 main NCDs declined 2.5 per cent/year on average, with reductions occurring in all the country’s regions. Decreases were relatively large for cardiovascular diseases (3.3 per cent/year) and for chronic respiratory diseases (4.4 per cent/year), although smaller for cancer (0.9 per cent/year) and diabetes (1.7 per cent/year). Conclusions: the 2 per cent decrease during the first year of monitoring is positive. The expectation is that when the national Plan actions are implemented, a similar decrease will be maintained, thus enabling the Plan’s proposed goal to be achieved...

OBJETIVO: describir la mortalidad por enfermedades crónicas no transmisibles (ECNT) en el período 2000-2011 y las proyecciones del Plan de Enfrentamiento de ECNT en Brasil para 2011-2022.MÉTODOS: estudio descriptivo de las tasas de mortalidad por enfermedades del aparato circulatorio, cáncer, diabetes y respiratoria crónica, con correcciones para causas mal definidas y subregistro de óbitos informados.RESULTADOS: hubo una disminución promedio de 2,5% al año en el conjunto de las cuatro principales ECNT en Brasil; hubo disminución en todas las regiones; hubo bajas importantes, de 3,3% para enfermedades cardiovasculares y de 4,4% para enfermedades respiratorias crónicas, con menores disminuciones para el cáncer, de 0,9%, y para la diabetes, de 1,7%.CONCLUSIONES: la reducción de 2% al año, ya en el primer año de monitoreo, es positiva; se espera, que con la implementación de las acciones previstas en el Plan de Enfrentamiento de las ECNT, y manteniéndose la reducción como la observada en la última década, que Brasil cumpla con la meta propuesta...