Estudio de los ingresos primarios del Hospital Vilardebó, en 2007 y 2008, procedentes de Montevideo: un abordaje desde la Geografía de la Salud / Study of primary income Vilardebó Hospital in 2007 and 2008, from Montevideo: an approach from the Geography of Health

Desde mediados del siglo XX se está de acuerdo en la necesidad de ampliar los enfoques en torno a la salud de las poblaciones, al reconocer que su dinámica se halla en función de factores biopsicosociales. La salud mental no escapa a ello. Se planteó como objetivo analizar la dinámica espacial de los ingresos primarios del hospital psiquiátrico Vilardebó, ocurridos durante 2007 y 2008, procedentes de la ciudad de Montevideo. Se realizó un estudio descriptivo, territorial y estadístico de la población objetivo, tomando como eje estructurante el enfoque territorial sanitario y los preceptos de la Geografía de la Salud como cuerpo conceptual. Se obtiene como resultado la visualización en la ciudad de Montevideo de espacios en los cuales coexisten factores socioterritoriales de alta vulnerabilidad desde los cuales se observaron las tasas de ingresos más elevadas al centro asistencial. El enfoque territorial en salud mental puede erigirse como una dimensión valiosa de análisis a la hora de establecer estrategias sanitarias

Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS) has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR) and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality. .

Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC=12%), Paraiba (APC=11.9%), and Piaui (APC=10.9%). CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.