Pediatric inflammatory multisystemic syndrome in Brazil: sociodemographic characteristics and risk factors to death

Abstract Objective: To determine the incidence of MIS-C in Brazil, describe the clinical and sociodemographic characteristics of the pediatric population affected by MIS-C and compare mortality and lethality outcomes with isolated Covid-19 and MIS-C cases. Methods: Observational and retrospective cohort study of cases of MIS-C associated with Covid-19 in the Brazilian population between 04/01/2020 and 04/17/2021. Data from the Ministry of Health's epidemiological bulletin up to the 15th epidemiological week of 2021, were used. The analyzes were descriptive through absolute and relative frequencies. The significance level is 5% in Stata 16.0 package. Results: Between 04/01/2020 and 04/07/2021, 903 cases of MIS-C associated with Covid-19 were notified in Brazil, of which, the largest part (55.26%) were male, between 0 and 4 years old (45.29%), from the Southeast region (38.76%). The deaths (61; 6.7%) were higher in the female gender, between 0 and 4 years old (47.54%) and in the Southeast region (34.43%). It was identified that the risk of death by MIS-C related to Covid-19 is 5.29 (CI = 2.83; 9.87 and P-value = <0.001) times higher in adolescents from 15-19 years old than in other age groups when compared to 0-4 years old children. Also, the residency in North region was as risk factor to death (RR = 3.72, IC = 1.29; 10.74 e P-value = 0.008). Conclusion: In this study, despite the numbers showing more deaths from zero to 4 years old, the risk for teenagers is notably higher. In addition, Brazil's Northern region is a risk factor that reaffirms social inequality and poor access to health.

Pediatric inflammatory multisystemic syndrome in Brazil: sociodemographic characteristics and risk factors to death.

OBJECTIVE: To determine the incidence of MIS-C in Brazil, describe the clinical and sociodemographic characteristics of the pediatric population affected by MIS-C and compare mortality and lethality outcomes with isolated Covid-19 and MIS-C cases. METHODS: Observational and retrospective cohort study of cases of MIS-C associated with Covid-19 in the Brazilian population between 04/01/2020 and 04/17/2021. Data from the Ministry of Health's epidemiological bulletin up to the 15th epidemiological week of 2021, were used. The analyzes were descriptive through absolute and relative frequencies. The significance level is 5% in Stata 16.0 package. RESULTS: Between 04/01/2020 and 04/07/2021, 903 cases of MIS-C associated with Covid-19 were notified in Brazil, of which, the largest part (55.26%) were male, between 0 and 4 years old (45.29%), from the Southeast region (38.76%). The deaths (61; 6.7%) were higher in the female gender, between 0 and 4 years old (47.54%) and in the Southeast region (34.43%). It was identified that the risk of death by MIS-C related to Covid-19 is 5.29 (CI = 2.83; 9.87 and P-value = <0.001) times higher in adolescents from 15-19 years old than in other age groups when compared to 0-4 years old children. Also, the residency in North region was as risk factor to death (RR = 3.72, IC = 1.29; 10.74 e P-value = 0.008). CONCLUSION: In this study, despite the numbers showing more deaths from zero to 4 years old, the risk for teenagers is notably higher. In addition, Brazil's Northern region is a risk factor that reaffirms social inequality and poor access to health.

Trends in bariatric surgeries in the Brazilian Federative Units, 2009-2019: a descriptive study.

OBJECTIVE: our objective is to describe the epidemiological distribution of hospitalizations and postoperative deaths, as well as the trends of bariatric surgeries performed by SUS in all Brazilian federative units (FUs) from an analysis of the period from 2009 to 2019. METHODS: This is an observational, descriptive ecological time-series study with quantitative and descriptive analysis, based on secondary data. The period analyzed was from 2009 to 2019. We collected, from DATASUS, data from obese men and women who were hospitalized after undergoing bariatric surgery. Prais-Winsten regression was performed to identify the trends. RESULTS: In the period, 83,829 bariatric surgeries were performed, of which 161 resulted in death, representing 0.19% of the procedures. We found an increasing trend in the number of surgeries for Brazil (ß=0.04; p<0.001), but 11 FUs showed a stationary trend and three, decreasing ones (six UFs did not have enough data to enter the analysis). In the North and Northeast regions, stationary trends prevailed, while in the Center-West, the decreasing trends, and in the South and Southeast, the increasing ones. CONCLUSIONS: we found an evident disparity between regions, suggesting deficiencies in access to health. By demonstrating which FUs and demographic characteristics have the lowest rates of surgeries, our study is able to direct public policies towards a more egalitarian Brazilian public health.

Trends in bariatric surgeries in the Brazilian Federative Units, 2009-2019: a descriptive study / Tendências das cirurgias bariátricas nas Unidades Federativas brasileiras, 2009-2019: um estudo descritivo

ABSTRACT Objective: our objective is to describe the epidemiological distribution of hospitalizations and postoperative deaths, as well as the trends of bariatric surgeries performed by SUS in all Brazilian federative units (FUs) from an analysis of the period from 2009 to 2019. Methods: This is an observational, descriptive ecological time-series study with quantitative and descriptive analysis, based on secondary data. The period analyzed was from 2009 to 2019. We collected, from DATASUS, data from obese men and women who were hospitalized after undergoing bariatric surgery. Prais-Winsten regression was performed to identify the trends. Results: In the period, 83,829 bariatric surgeries were performed, of which 161 resulted in death, representing 0.19% of the procedures. We found an increasing trend in the number of surgeries for Brazil (β=0.04; p<0.001), but 11 FUs showed a stationary trend and three, decreasing ones (six UFs did not have enough data to enter the analysis). In the North and Northeast regions, stationary trends prevailed, while in the Center-West, the decreasing trends, and in the South and Southeast, the increasing ones. Conclusions: we found an evident disparity between regions, suggesting deficiencies in access to health. By demonstrating which FUs and demographic characteristics have the lowest rates of surgeries, our study is able to direct public policies towards a more egalitarian Brazilian public health.

RESUMO Objetivo: nosso objetivo é descrever a distribuição epidemiológica das internações e óbitos pós-operatórios, bem como as tendências das cirurgias bariátricas realizadas pelo SUS em todas as unidades federativas (UFs) brasileiras a partir de uma análise do período de 2009 a 2019. Métodos: trata-se de um estudo observacional descritivo ecológico de série temporal com análise quantitativa e descritiva, com base em dados secundários. O período analisado foi de 2009 a 2019. Coletamos, no DATASUS, dados de homens e mulheres que possuem obesidade e foram internados após terem sido submetidos à cirurgia bariátrica. A regressão de Prais-Winsten foi utilizada para identificar as tendências. Resultados: no período, 83.829 cirurgias bariátricas foram realizadas, tendo 161 evoluído para óbitos, o que representa 0,19% dos procedimentos. Encontramos uma tendência crescente no número de cirurgias para o Brasil (β=0,04; p<0,001), mas 11 UFs apresentaram tendência estacionária e três, decrescente (seis UFs não tinham dados suficientes para entrar na análise). Nas regiões Norte e Nordeste prevaleceram tendências estacionárias, enquanto no Centro-Oeste, as decrescentes, e no Sul e Sudeste, as crescentes. Conclusões: encontramos uma evidente disparidade entre as regiões, sugerindo deficiências de acesso à saúde. Ao demonstrar quais UFs e características demográficas apresentam menores índices de cirurgias, nosso estudo é capaz de direcionar políticas públicas para uma saúde pública brasileira mais igualitária.

A simple awareness campaign to promote food waste reduction in a University canteen.

Food waste has important environmental, social and economic impacts and increasing attention has been given lately to the unparalleled scale of food waste in the food supply chain worldwide. An initiative aiming to reduce food waste was tested at the School of Agriculture canteen (University of Lisbon, Portugal). The "Clean dish, clean conscience!" initiative consisted of a simple and inexpensive education campaign to raise awareness of reducing plate waste, by establishing the connection between food waste and personal behaviour. As a first stage plate waste from canteen users was measured over a 10 day period. After this period, a waste consumption index and per capita waste consumption were calculated to evaluate the level of satisfaction of the consumer and the related concern about food wastage, and was classified as Bad. After this first stage it was concluded that the users did not have strong convictions about avoiding food waste. During the second stage of the project an education campaign was implemented with plate waste being monitored for a further 16 days to assess the effectiveness of the campaign. The approach consisted of displaying simple and affordable informative posters in strategic areas of the canteen with simple messages reminding not to accept food they knew they would not eat. This led to a mean reduction in the waste consumption index of ∼15%. A parallel action encouraging separation of organic and inorganic waste was implemented as well, with an active participation of >70% of the users. The initiative achieved its objective of reducing plate waste by raising awareness of the daily food waste problem at the institution's canteen and by suggesting "how-to" actions for reducing such waste. This study showed how avoidable waste can be reduced simply by making students aware of the topic of food waste. Simple strategies may be useful to improve behaviours and increase sustainability of the canteens at Universities although this proved to be only efficient with the collaboration of the canteen staff that needs solid education. From the results, a set of measures was presented to the University Social Services for adoption to ensure a permanent reduction of food waste and recyclables in the University canteens.

Decomposition rate and enzymatic activity of composted municipal waste and poultry manure in the soil in a biofuel crops field.

BACKGROUND: Biofuel crops are gaining importance because of the need to replace non-renewable sources. Also, due to the increasing amounts of wastes generated, there is the need to recycle them to the soil, both to fertilize crops and to improve soil physical properties through organic matter increase and microbiological changes in the rhizosphere. We therefore studied the influence of six biofuel crops (elephant grass, giant cane, sugarcane, blue gum, black cottonwood, willow) on the decomposition rate and enzymatic activity of composted municipal solid waste and poultry manure. Organic amendments were incubated in the field (litterbag method), buried near each plant or bare soil. Biomass decrease and dehydrogenase, urease and acid phosphatase level in amendments was monitored over a 180-day period. Soil under the litterbags was analysed for the same enzymatic activity and organic matter fractions (last sampling). After 365 days, a fractionation of organic matter was carried out in both amendments and soil under the litterbags. RESULTS: For compost, willow and sugarcane generally led to the greatest enzymatic activity, at the end of the experiment. For manure, dehydrogenase activity decreased sharply with time, the smallest value near sugarcane, while phosphatase and urease generally presented the highest values, at the beginning or after 90 days' incubation. Clustering showed that plant species could be grouped based on biomass and enzymes measured over time. CONCLUSIONS: Plant species influenced the decomposition rate and enzymatic activities of the organic amendments. Overall, mineralization of both amendments was associated with a greater urease activity in soils. Dehydrogenase activity in manure was closely associated with urease activity. © 2016 Society of Chemical Industry.