[Epidemiology of cerebrovascular disease in Joinville, Brazil. An institutional study]. / Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil. Estudo Institucional.

The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case ráte (in 30 days lethality), frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients were submited to at least one computed tomography scanning. The episodes of cerebral infarcts were divided in pathological sub-types. Results showed that the annual incidence adjusted to the age of first stroke episode was 156/100,000. The distribution by diagnosis was: 73.4% for cerebral infarct, 18.4% for cerebral hemorrhage and 7.5% for subarachnoid hemorrhage. The annual standard mortality rate was 25/100,000. The fatality case global rate in 30 days was 26%. Hypertension, previous stroke and diabetes were the most frequent risk factors. Only 25% of the patients were assisted within three hours of the onset of stroke. We concluded that the incidence rate of first episode of stroke is high in institutionalized patient in Joinville, Brazil. The mortality and fatality--case rates are similar to the ones of other populations.

[Osteomyoarticular injuries in a physical conditioning program]. / Lesões osteomioarticulares no programa de condicionamento físico.

From the follow-up of one hundred and thirty patients in a physical conditioning program during the period of one year, partially disabling lesions with preliminary complaints were observed at the beginning of the program in thirteen patients, and lesions during the development of the program were observed in nineteen patients. Within the first group, four patients had to quit the program, two temporarily and two definitively. In the second group, five patients had to interrupt the program for periods varying from twenty days to two months. In both groups, treatment involving physical agents, kinesiotherapy and drugs was proposed. Interruptions in the physical conditioning program for periods longer than three weeks imply in considerable reduction of the cardiovascular benefits. The clinician must be aware of the fact that sedentary patients have not only cardiovascular, but also musculoskeletal deconditioning. These patients must be evaluated by the physiatrist in order that the disabling lesions be avoided and treated.