Tendência do risco de morte por doenças circulatórias, cerebrovasculares e isquêmicas do coração em 11 capitais do Brasil de 1980 a 1998 / Trends of the risk of death due to circulatory, cerebrovascular, and ischemic heart diseases in 11 Brazilian capitals from 1980 to 1998

OBJECTIVE: To assess the trends of the risk of death due to circulatory (CD), cerebrovascular (CVD), and ischemic heart diseases (IHD) in 11 Brazilian capitals from 1980 to 1998. METHODS: Data on mortality due to CD, CVD and IHD were obtained from the Brazilian Health Ministry, and the population estimates were calculated by interpolation with the Lagrange method based on census data from 1980 and 1991 and the population count of 1996. The trends were analyzed with the multiple linear regression method. RESULTS: CD showed a trend towards a decrease in most capitals, except for Brasília, where a mild increase was observed. The cities of Porto Alegre, Curitiba, Rio de Janeiro, Cuiabá, Goiânia, Belém, and Manaus showed a decrease in the risk of death due to CVD and IHD, while the city of Brasília showed an increase in CVD and IHD. The city of Säo Paulo showed a mild increase in IHD for individuals of both sexes aged 30 to 39 years and for females aged 40 to 59 years. In the cities of Recife and Salvador, a reduction in CD was observed for all ages and both sexes. In the city of Recife, however, an increase in IHD was observed at younger ages (30 to 49 years), and this trend decreased until a mild reduction (-4 percent) was observed in males ³ 70 years. CONCLUSION: In general, a reduction in the risk of death due to CD and an increase in IHD were observed, mainly in the cities of Recife and Brasília

Aspectos éticos e legais da reanimaçäo cardiorrespiratória / Ethical and legal aspects of cardiopulmonary resuscitation

A reanimaçäo cardiorrespiratória tem como finalidade restaurar a funçäo circulatória e respiratória, preservando a vida e limitando as seguelas das vítimas de parada cardiorrespiratória. Muitas vezes é difícil decidir quando indicar ou näo, ou mesmo interromper a reanimaçäo. Nesse contexto, a equipe médica, o paciente e seus familiares devem tomar decisöes baseadas em conhecimentos científicos, preceitos éticos, morais e legais. A legislaçäo e o Código Brasileiro de Ética Médica, ao mesmo tempo que garantem o acesso ao tratamento adequado a qualquer um que necessite, também coíbem, a instituiçäo de medidas terapêuticas fúteis ou desnecessárias. Esse artigo tem como propósito discutir algumas medidas que podem ser tomadas pelos pacientes, seus médicos e familiares para minimizar as angústias de tomada de decisäo num momento em que poucos segundos podem significar a diferença entre a vida e a morte.