Temporal trend analysis of hospitalizations and in-hospital deaths due to female breast cancer in the state of Alagoas from 2009 to 2019: a cross-sectional study

ABSTRACT BACKGROUND: Breast cancer is a common neoplasm in women worldwide. Its varying patterns of incidence and clinical prognosis in Brazil make it an important and complex public health problem that needs to be solved. OBJECTIVES: To analyze the temporal dynamics of hospital admissions and deaths due to female breast cancer in the state of Alagoas, Brazil, from 2009 to 2019. DESIGN AND SETTING: Cross-sectional study including secondary data from hospital admissions and deaths due to female breast cancer in Alagoas. METHODS: A joinpoint regression model was constructed for temporal analysis of hospital admissions and deaths due to female breast cancer in Alagoas, over this period. The hospital information system of the Department of Informatics of the National Health System was used. RESULTS: There were 5,801 hospitalizations and 633 hospital deaths due to neoplasm in Alagoas over the period. The age group from 50 to 59 years old stood out, corresponding to 28.1% of hospitalizations and 31.1% of registered deaths. An increasing trend in the rate of hospital admissions was observed (average annual percentage change, AAPC = 14.0; P-value < 0.001), from 14.9/100,000 inhabitants in 2009 to 53.6 in 2019. There was a growth trend in the in-hospital mortality rate (AAPC = 19.8; P-value < 0.001), from 6.3% in 2009 to 11.0% in 2019. CONCLUSION: The results indicated an increasing trend of hospital admissions and mortality rates in the state of Alagoas, with a higher percentage of hospitalizations and deaths in the 50-59 age group.

Obesity and the COVID-19: Analysis of the clinical and epidemiological profiles of 138 individuals

SUMMARY INTRODUCTION: Coronavirus disease 2019 (COVID-19) is the disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the ongoing obesity pandemic, its coexistence with COVID-19 becomes worrying and has a less favorable outcome. OBJECTIVE: This study aimed to describe the clinical and epidemiological profiles of confirmed cases of COVID-19 in individuals with obesity in the state of Alagoas. METHODS: The observational cross-sectional study involving 138 confirmed cases of COVID-19 who had obesity as a comorbidity reported at the time of notification of the disease. The data were collected from the COVID-19 database in the state of Alagoas, and the variables analyzed were sex, age (and age group), race/color, outcome, clinical manifestations, and associated comorbidities. The Kolmogorov-Smirnov, Mann-Whitney U, χ², or Fisher's exact tests were performed as appropriate. The significance was set at 5 and 95% confidence intervals. RESULTS: There was a predominance of females (55.1%; n=76), aged <60 years (70.3%; n=97) and brown race/color (n=76; 55.1%). The most prevalent symptoms were cough (n=84; 60.9%), fever (n=78; 56.5%), headache (n=36; 26.1%), and adynamia (n=28; 20.3%). The median age was 49 years, with no difference between genders (p=0.340). The lethality rate was 17.4% (n=24), being higher in the male population (22.6% in males and 13.2% in females). Of the 24 deaths, 13 (54.2%) were recorded in the elderly people. In addition to obesity, 54.3% (n=75) had systemic arterial hypertension and 30.4% (n=42) had diabetes mellitus. There was no difference in the prevalence of comorbidity between genders. CONCLUSIONS: The profile studied demonstrates that obesity represents a challenge for coping with COVID-19.

Determinantes Sociais da Saúde vs Determinação Social da Saúde: Uma aproximação conceitual

Objetivo: Explorar os conceitos de determinantes sociais da saúde e de determinação social da saúde, estabelecendo as principais diferenças e críticas. Metodologia: Trata-se de uma revisão bibliográfica utilizando o método hipotético-dedutivo. Resultados e Discussão: Diferenças históricas, epistemológicas e de arcabouço teóricometodológico podem ser evidenciadas na construção e aplicação dos conceitos de determinantes sociais e de determinação social. Complementares em determinados momentos, excludentes em outros. Próximos num mesmo objetivo, que é tentar entender o processo saúde-doença. Conclusão: Os dois modelos trazem contribuições importantes para a compreensão do fenômeno saúde-doença, possuindo vantagens e desvantagem, fortalezas e fragilidades