Epidemiologia e Servicos de Saude最新文献

Objective: To characterize the survival of elderly people with HIV infection who had follow-up at a reference service in Jaboatão dos Guararapes, Pernambuco, Brazil.

Methods: This is a retrospective cohort of elderly people who began follow-up between 2006 and 2021. Kaplan-Meier survival analysis was used. The Cox model was applied to calculate the hazard ratio (HR) and 95% confidence interval (95%CI) of survival based on the study variables.

Results: 116 elderly people were analyzed, the majority (n=83) were 60-69 years old and were diagnosed after the age of 60 (n=45). Risk of death was higher among elderly people who were hospitalized during the study period (HR 4.83; 95%CI 1.07; 21.79). Nine people died from HIV-related causes and average survival time was 76.5±48.5 months. In the first year of the study, probability of survival was greater than 96%.

Conclusion: Survival varied from less than one month to more than 195 months. Among the sociodemographic and clinical factors studied, only hospitalization showed significant association with occurrence of deaths among the elderly. Although the study was carried out in just one service, these results can contribute to guiding care strategies for elderly people living with HIV.

Objective: This article organizes the origin and historical context of the second edition of the Dietary Guidelines for the Brazilian Populationten years after its publication, analyzing its contributions to the science of Nutrition and public food and nutrition policies in Brazil and around the world.

Methods: This is a narrative review prepared based on consultation of scientific articles, gray literature and journalistic publications, among others.

Results: The Guide resulted from scientific evidence and subsequently became an object of study. Its being based on the Nova Food Classification brought a new paradigm to nutritional science. Its publication was the basis of a series of public policies that encourage consumption of fresh or minimally processed foods and mitigate consumption of ultra-processed options.

Conclusion: The Guide was able to induce and guide health actions and other public policies to promote adequate and healthy eating. It also boosted scientific research, having national and global influence.

Objective: To describe an interconsultation project with specialists and family health teams participating in a telemedicine project in the state of Rio Grande do Norte, Brazil.

Methods: Descriptive study with evaluation of TeleNordeste Project interconsultations. Data collection began in November 2022, with consultations with a cardiologist, neurologist, psychiatrist and endocrinologist made available to primary health centers. Patients over 18 years of age were included in the study. Quantitative data were described as medians and percentiles, qualitative data were measured in absolute frequency and percentage.

Results: 572 patients were included and carried out 847 consultations; 71% were women, the median age were 50 years, 96.7% of patients had chronic non-communicable diseases. The median of the waiting time for consultation was 7 days. In total, 565 patients had their complaints completely resolved and did not need to be referred to a specialized service.

Conclusion: The TeleNordeste Project brought to Rio Grande do Norte a type of medical care facilitated by digital health, with the possibility of agile contact and easy access in primary health care to cardiologists, neurologists, psychiatrists and endocrinologists, enabling improved care and increased effectiveness in real time.

Objective: To describe the profile of medication use in women with triple-negative breast cancer treated between 2018 and 2019 in a Brazilian public hospital.

Methods: Descriptive and retrospective study, with data obtained from the Hospital Cancer Registry and physical and electronic medical records from a public hospital that is a reference in cancer treatment, in Rio de Janeiro. Descriptive analyses and analyses of time to treatment failure and overall survival were performed using the Kaplan Meier method.

Results: Of the 176 patients, 39.0% were under 50 years of age and 47.7% were diagnosed at an advanced stage. Use of 12 chemotherapy regimens was identified, with neoadjuvant or adjuvant intent, for treatment of triple-negative breast cancer. The most commonly used treatment regimen included doxorubicin, cyclophosphamide and taxanes (docetaxel or paclitaxel). After 180 days, 76.1% of patients remained on the initial treatment. Average time until treatment failure was 7.6 months for those who followed the main regimen. Median overall survival was 34 months, and 55.7% of patients died by the end of the follow-up period (48 months).

Conclusion: The results showed that treatment with doxorubicin, cyclophosphamide and taxanes (docetaxel or paclitaxel) was the most used in the patients analyzed, that average time to treatment failure using this regimen was less than one year and that more than half of the patients died within four years after diagnosis.

Objective: To assess association between sociodemographic factors, presence of licit or illicit psychoactive substances, and types of legal death in Ceará state, Brazil.

Methods: Cross-sectional study based on autopsy data and toxicology tests on victims of cases registered by the Ceará Forensic Expert service, from 2015 to 2019.

Results: Of the 4,198 cases analyzed, 55.6% were positive for licit and/or illicit substances, with greater frequency of benzodiazepines (22.4%) and cocaine (21.7%) among males (45.0%), young adults (58.7%), single people (49.0%), and those with low education levels (52.8%). Association was found between benzodiazepines (29.5%) and tricyclic antidepressants (15.6%) and suicides; cocaine (28.1%) and cannabis (27.1%) and homicides; and cocaine (28.2%) and tricyclic antidepressants (5.9%) and suspicious deaths.

Conclusion: Sociodemographic factors were associated with the use of psychoactive substances and types of legal death. Benzodiazepines and cocaine were the most frequent substances in suicide and homicide cases, respectively.

Objective: To investigate the evolution of prevalence of catastrophic health expenditure in the Brazilian Federal District at three different times (2003, 2009 and 2018), as well, to identify the composition of outof- pocket expenditure in the respective years.

Method: Time series study, using descriptive data from the Family Budget Survey. Prevalence was stratified by consumption quintiles.

Results: 754 households were selected as a sample in 2003, 695 in 2009 and 1,000 in 2018. Taking a 10% consumption threshold, prevalence of catastrophic expenditure was 12.3% (95%CI 9.6;14.9) in 2003, 15.3% (95%CI 12.1;18.3) in 2009 and 14.1% (95CI% 11.8;16.2) in 2018. Households with lower income had higher prevalence of catastrophic expenditure. Medicines have a greater burden on expenditure of low-income families.

Conclusions: There was an increase in prevalence of catastrophic expenditure in the Federal District. Medicines were the main expense for the poorest families.