ABSTRACT
The objective of this study was to analyze the trends in neonatal mortality in Brazil from 2007 to 2017. This is an ecological time series study carried out with data from the Mortality Information System and the Information System on Live Births, analyzed through of Prais-Winsten regression. There was an average neonatal mortality rate of 9.46 deaths/1,000 live births in the analyzed period, with a reduction of 2.15% per year. There was a greater decline in early neonatal mortality compared to late neonatal mortality. There was an upward trend of neonatal deaths among preterm infants, newborns with extremely low birth weight, born by cesarean delivery, children of mothers over 30 years of age and of mothers with more than eight years of schooling. Regarding the causes of death, there was an increasing trend of deaths due to congenital malformations, infectious diseases, endocrine, nutritional and metabolic diseases and external causes. Still, there was an upward trend in preventable deaths by adequate care for women during pregnancy and for other causes that are not clearly preventable. Despite the general reduction in deaths, it is necessary to intensify public policies for adequate care for women during pregnancy to ensure improvement in the other indicators analyzed.
O objetivo deste estudo foi analisar a tendência da mortalidade neonatal no Brasil de 2007 a 2017. Trata-se de um estudo ecológico de série temporal, realizado com dados do Sistema de Informações sobre Mortalidade e do Sistema de Informações sobre Nascidos Vivos, analisados por meio de regressão de Prais-Winsten. Verificou-se uma taxa média de mortalidade neonatal de 9,46/1.000 nascidos vivos no período, com redução de 2,15% ao ano. Houve maior declínio da mortalidade neonatal precoce, comparada com a tardia. Destaca-se tendência crescente dos óbitos neonatais entre neonatos pré-termos, com extremo baixo peso, nascidos de parto cesáreo, filhos de mães com idade superior a 30 anos e escolaridade superior a oito anos de estudo. Em relação às causas de morte, verificou-se tendência crescente dos óbitos por malformações congênitas, doenças infecciosas, doenças endócrinas, nutricionais e metabólicas e causas externas. Constatou-se, ainda, tendência crescente nos óbitos evitáveis por adequada atenção à mulher na gestação e por demais causas não claramente evitáveis. Apesar da redução geral dos óbitos, faz-se necessário intensificar as políticas públicas de assistência adequada à mulher na gestação para garantir melhoria nos demais indicadores analisados.
Subject(s)
Infant, Premature , Perinatal Death , Brazil/epidemiology , Child , Female , Humans , Infant , Infant Mortality , Infant, Newborn , Live Birth , PregnancyABSTRACT
Resumo O objetivo deste estudo foi analisar a tendência da mortalidade neonatal no Brasil de 2007 a 2017. Trata-se de um estudo ecológico de série temporal, realizado com dados do Sistema de Informações sobre Mortalidade e do Sistema de Informações sobre Nascidos Vivos, analisados por meio de regressão de Prais-Winsten. Verificou-se uma taxa média de mortalidade neonatal de 9,46/1.000 nascidos vivos no período, com redução de 2,15% ao ano. Houve maior declínio da mortalidade neonatal precoce, comparada com a tardia. Destaca-se tendência crescente dos óbitos neonatais entre neonatos pré-termos, com extremo baixo peso, nascidos de parto cesáreo, filhos de mães com idade superior a 30 anos e escolaridade superior a oito anos de estudo. Em relação às causas de morte, verificou-se tendência crescente dos óbitos por malformações congênitas, doenças infecciosas, doenças endócrinas, nutricionais e metabólicas e causas externas. Constatou-se, ainda, tendência crescente nos óbitos evitáveis por adequada atenção à mulher na gestação e por demais causas não claramente evitáveis. Apesar da redução geral dos óbitos, faz-se necessário intensificar as políticas públicas de assistência adequada à mulher na gestação para garantir melhoria nos demais indicadores analisados.
Abstract The objective of this study was to analyze the trends in neonatal mortality in Brazil from 2007 to 2017. This is an ecological time series study carried out with data from the Mortality Information System and the Information System on Live Births, analyzed through of Prais-Winsten regression. There was an average neonatal mortality rate of 9.46 deaths/1,000 live births in the analyzed period, with a reduction of 2.15% per year. There was a greater decline in early neonatal mortality compared to late neonatal mortality. There was an upward trend of neonatal deaths among preterm infants, newborns with extremely low birth weight, born by cesarean delivery, children of mothers over 30 years of age and of mothers with more than eight years of schooling. Regarding the causes of death, there was an increasing trend of deaths due to congenital malformations, infectious diseases, endocrine, nutritional and metabolic diseases and external causes. Still, there was an upward trend in preventable deaths by adequate care for women during pregnancy and for other causes that are not clearly preventable. Despite the general reduction in deaths, it is necessary to intensify public policies for adequate care for women during pregnancy to ensure improvement in the other indicators analyzed.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Child , Infant, Premature , Perinatal Death , Brazil/epidemiology , Infant Mortality , Live BirthABSTRACT
Background: In veterinary medicine, although primary lung tumors are rare compared to metastatic malignant neoplasms,an increase in the number of primary lung tumors in dogs has been reported in the past decades. Consequently, identifyingepidemiological, clinical, and pathological features of these neoplasms is essential for early and precise diagnosis. Thispaper aimed to report a case of a non-metastatic primary solid pulmonary adenocarcinoma in a dog and review the clinical,pathological, and immunohistochemical aspects of this neoplasm.Case: An 8-year-old female Cocker Spaniel was admitted to the Small Animals Veterinary Hospital of the Rural FederalUniversity of Rio de Janeiro (Brazil) with a history of progressive weight loss and clinical dyspnea. Physical examinationrevealed the following: body temperature, 38.7ºC; capillary refill time, one second; heart rate, 104 beats/min; respiratoryrate, 40 breaths/min; pallor mucosa; blood glucose, 133 mg/dL; and body score, 2 (1-9). A thoracic radiograph revealeda diffuse radiopaque pattern of the pulmonary parenchyma, pleural effusion, and a large mass that extended through bothhemithoraces. An ultrasound-guided cytological examination was performed and displayed moderate cellularity in a bloodybackground. Cells presented distinct cell borders, large bluish cytoplasm, round hyperchromatic or vesicular nuclei, andevident nucleoli. Three months after the first clinical consultation, the dogs state kept deteriorating and the owner optedfor the euthanasia. Autopsy of the lungs showed multiple, poorly defined, coalescent nodules with an average size of20.0×15.0×10.0 cm. The nodules occupied roughly 70% of the pulmonary...(AU)
Subject(s)
Animals , Dogs , Adenocarcinoma of Lung/pathology , Adenocarcinoma of Lung/veterinary , Immunohistochemistry/veterinary , Lung Neoplasms/veterinaryABSTRACT
Background: Congenital cardiac diseases are a common cause of death in puppies. Tricuspid valve dysplasia is characterized by thickening and displacement of the leaflets of the tricuspid valve, agenesis of the valves, and incomplete separationof valve components. Papillary muscles may fuse and display shortened or absent chordae tendineae that contribute totricuspid regurgitation. Diagnostic features of tricuspid valve dysplasia include cardiomegaly with massive right atriumenlargement on thoracic radiography and tricuspid insufficiency on an ultrasound. We aimed to describe clinicopathological findings in a dog (Canis familiaris) with tricuspid dysplasia.Case: We aimed to describe tricuspid valve dysplasia in a dog referred for necropsy at the Anatomical Pathology Sector ofThe Rural Federal University of Rio de Janeiro, Brazil, with a clinical history of abdominal swelling, dyspnea, cyanosis,ascites, and prostration. Echocardiography and abdominal ultrasound revealed right ventricular enlargement, hepatomegaly,and splenomegaly. Examination of the heart showed prominent enlargement, thickening and dilation of the right chambers,thickening of the tricuspid leaflets, and moderately shortened chordae tendineae. The liver was enlarged, with a nutmegpattern, and foci of clotting and fibrin adhesions in the lateral right lobule.Discussion: Epidemiological, clinical, and pathological findings were consistent with tricuspid valve dysplasia. Althoughstructural abnormalities of the tricuspid and mitral valves are well known in fetuses and neonates, congenital and secondary tricuspid malformations are rare in dogs. The survival rate is associated with the severity of heart lesions. Tricuspidvalve dysplasia is mostly observed in large-breed...
Subject(s)
Animals , Dogs , Heart Defects, Congenital/veterinary , Tricuspid ValveABSTRACT
Background: In veterinary medicine, although primary lung tumors are rare compared to metastatic malignant neoplasms,an increase in the number of primary lung tumors in dogs has been reported in the past decades. Consequently, identifyingepidemiological, clinical, and pathological features of these neoplasms is essential for early and precise diagnosis. Thispaper aimed to report a case of a non-metastatic primary solid pulmonary adenocarcinoma in a dog and review the clinical,pathological, and immunohistochemical aspects of this neoplasm.Case: An 8-year-old female Cocker Spaniel was admitted to the Small Animals Veterinary Hospital of the Rural FederalUniversity of Rio de Janeiro (Brazil) with a history of progressive weight loss and clinical dyspnea. Physical examinationrevealed the following: body temperature, 38.7ºC; capillary refill time, one second; heart rate, 104 beats/min; respiratoryrate, 40 breaths/min; pallor mucosa; blood glucose, 133 mg/dL; and body score, 2 (1-9). A thoracic radiograph revealeda diffuse radiopaque pattern of the pulmonary parenchyma, pleural effusion, and a large mass that extended through bothhemithoraces. An ultrasound-guided cytological examination was performed and displayed moderate cellularity in a bloodybackground. Cells presented distinct cell borders, large bluish cytoplasm, round hyperchromatic or vesicular nuclei, andevident nucleoli. Three months after the first clinical consultation, the dogs state kept deteriorating and the owner optedfor the euthanasia. Autopsy of the lungs showed multiple, poorly defined, coalescent nodules with an average size of20.0×15.0×10.0 cm. The nodules occupied roughly 70% of the pulmonary...
Subject(s)
Animals , Dogs , Adenocarcinoma of Lung/pathology , Adenocarcinoma of Lung/veterinary , Immunohistochemistry/veterinary , Lung Neoplasms/veterinaryABSTRACT
Background: Congenital cardiac diseases are a common cause of death in puppies. Tricuspid valve dysplasia is characterized by thickening and displacement of the leaflets of the tricuspid valve, agenesis of the valves, and incomplete separationof valve components. Papillary muscles may fuse and display shortened or absent chordae tendineae that contribute totricuspid regurgitation. Diagnostic features of tricuspid valve dysplasia include cardiomegaly with massive right atriumenlargement on thoracic radiography and tricuspid insufficiency on an ultrasound. We aimed to describe clinicopathological findings in a dog (Canis familiaris) with tricuspid dysplasia.Case: We aimed to describe tricuspid valve dysplasia in a dog referred for necropsy at the Anatomical Pathology Sector ofThe Rural Federal University of Rio de Janeiro, Brazil, with a clinical history of abdominal swelling, dyspnea, cyanosis,ascites, and prostration. Echocardiography and abdominal ultrasound revealed right ventricular enlargement, hepatomegaly,and splenomegaly. Examination of the heart showed prominent enlargement, thickening and dilation of the right chambers,thickening of the tricuspid leaflets, and moderately shortened chordae tendineae. The liver was enlarged, with a nutmegpattern, and foci of clotting and fibrin adhesions in the lateral right lobule.Discussion: Epidemiological, clinical, and pathological findings were consistent with tricuspid valve dysplasia. Althoughstructural abnormalities of the tricuspid and mitral valves are well known in fetuses and neonates, congenital and secondary tricuspid malformations are rare in dogs. The survival rate is associated with the severity of heart lesions. Tricuspidvalve dysplasia is mostly observed in large-breed...(AU)
Subject(s)
Animals , Dogs , Tricuspid Valve , Heart Defects, Congenital/veterinaryABSTRACT
Resumo Este artigo busca refletir sobre a dualidade entre soma e psique, que tende a obscurecer a unidade originária a partir da qual esses dois entes podem aparecer e serem compreendidos. Em seguida, conduz o leitor para uma compreensão crítica, lidando com aspectos da tradição em psicossomática e com base na fenomenologia-hermenêutica de Martin Heidegger e na Daseinsanalyse de Medard Boss. Tanto o filósofo alemão quanto o psiquiatra suíço operam não somente a desconstrução da ótica tradicional, mas também do próprio conceito de psicossomática. Mostram que o modo de acesso ao fenômeno produz a dicotomia, sendo, portanto, necessário modificá-lo a fim de apreender o que está em jogo no problema do corpo e do adoecer, isto é, a própria existência do homem que se revela todo o tempo através do corporar (Leiben), que é sempre gesto. Este último significa, em Heidegger, toda expressão do homem, indissociável de seu existir no mundo como Dasein. Este estudo tem a expectativa de contribuir na busca de outros fundamentos para a prática do cuidado psicológico em saúde....(AU)
Abstract The article presents aspects of the psychosomatic tradition and attempts to reflect on the duality generated between soma and psyche, which tends to overshadow the original unity from which these two entities can appear and be understood. Subsequently, it leads the reader to a critical comprehension based on Martin Heidegger’s hermeneutic phenomenology and Medard Boss’ dasensanalysis. Both the German philosopher and the Swiss psychiatrist dismantle not only the traditional view but also the concept of psychosomatics. They argue that the route of access to the phenomenon produces a dichotomy, which therefore proves itself necessary to be modified so that one can perceive what is at stake in terms of the body and of getting ill, i.e., the human existence which at all times reveals itself through bodying (Leiben), which is always gesture. The former means, in Heidegger, each human expression which is indistinguishable from their existence in the world as Dasein. Thus, this article contributes to the search of other fundamentals for the psychological practice in healthcare....(AU)
Resumen El artículo presenta los aspectos de la tradición en psicosomática y reflexiona sobre la dualidad engendrada entre soma y psique, que tiende a ocultar la unidad originaria desde la que estos dos entes pueden aparecer y ser comprendidas. Luego, conduce al lector a una comprensión crítica basada en la fenomenología- hermenéutica de Martin Heidegger y el Daseinanalyse de Medard Boss. Tanto el filósofo alemán como el psiquiatra suizo hacen no solo la deconstrucción de la óptica tradicional, sino también del propio concepto de psicosomática. Ellos enseñan que el modo de acceso al fenómeno produce dicotomía y por lo tanto, es necesario modificarlo para captar lo que está en juego en el problema del cuerpo y del enfermar, es decir, la existencia misma del hombre se revela todo el tiempo por medio de la corporalidad (Leiben), que siempre es gesto. Gesto para Heidegger significa toda expresión del hombre, inseparable de su existencia en el mundo como Dasein. Se cree que con esto se está contribuyendo a la búsqueda de otros fundamentos para la práctica del cuidado psicológico en las instituciones que cuidan de la salud....(AU)