In the course of an epidemiological survey in four provinces of Veneto (northeastern Italy) 67 spinal muscular atrophy (SMA) cases (types I, II and III) were recorded. The survey spanned the period 1960–1983 and involved 859,891 consecutive live-born infants in a population of 2,635,800 inhabitants. The overall prevalence at birth for SMA types I, II and IIIwas 7.8/100,000 live births. Type I alone accounted for 4.1/100,000 live births. If the hypothesis that SMA types I, II and III are clinical manifestations of allelic mutations is assumed, the mutation rate would be about 70 X 10^–6 and the frequency of the heterozygotes 1 in 57.

The aim of this study was to describe metabolic changes in HIV/AIDS patients according to the treatment regimen. It was a retrospective cohort conducted from 2002 to 2014. Researchers surveyed clinical variables and treatment regimen of 538 individuals. They used measures of central tendency and marginal logistic regression to determine the influence of the treatment regimen on clinical variables over time; survival was estimated using Kaplan-Meier curves. 56.2% of patients were male, 82.2% white, 33.8% had 4 to 7 years of study, 49.2% were married, 98.5% had sexual transmission, and 89.0% were heterosexuals. During the study period, 24.4% had hypertension, 18.2% changed cholesterol, 39.7% low HDL, 51.3% high triglycerides and 33.3% hyperglycemia. Treatment regimens with nucleotide reverse transcriptase inhibitors associated with protease inhibitors, and the association of different classes of antiretrovirals have been associated with greater lipid changes. Higher metabolic changes were observed in patients with longer treatment time. It is concluded that preventive measures, as well as early treatment, can contribute to minimize the risks of developing cardiovascular diseases.

Objective: To identify factors that determine the negative perception of the health of the Brazilian elderly, considering sociodemographic conditions, functional limitations and illness, patterns of utilization of health services and oral health condition. Method: A cross-sectional study with data from the National Health Survey (2013), involving 23,815 elderly persons was carried out. Once the database was treated, dimensionality reduction was performed using the Waikato Environment for Knowledge Analysis. The variables related to health perception were evaluated through logistic regression to measure the magnitude of the associations. Health perception and 36 independent variables were considered as outcome variables. Results: The variables most strongly related to the negative perception of the health of the elderly were illiteracy (OR=1.48), low educational level, total difficulty in performing instrumental activities of daily living (OR=2.04), impossibility of performing any activity (OR=3.20), presence of a diagnosis of physical or mental illness (OR=2.44), negative self-perception of oral health (OR=1.92), an increased need for health services in recent weeks (OR=1.16), medical visits and hospitalization in the last 12 months (OR=1.40). Conclusion: The use of multidimensional methodologies can identify the influence of determinants of a negative perception of health among Brazilian elderly persons, and can support the formulation of public health policies aimed at the elderly population.

This ecological study aimed to describe the spatial distribution of cardiovascular mortality in Paraná State, Brazil (1989-1991

Avaliação da satisfação dos usuários com os serviços do consórcio intermunicipal de saúde do noroeste do ParanáEvaluation of users satisfaction with the services of the intermunicipal health consortia at the northwest of Paraná state

The scope of this paper is to discuss the evolution of mortality due to cervical cancer in the State of Paraná, Brazil, between 1980 and 2000 and analyze the socioeconomic differentials in each region of the State. Mortality data were gathered from the System for Information on Mortality by age and town of residence. Age-adjusted death rates were calculated for 22 regions of the state in each year. Comparative analysis evaluated socioeconomic indicators associated with regions that showed either stationary or increasing mortality trends. Cervical cancer deaths increased in the state of Paraná, with an annual percentage increase of 1.68% (1.20 to 2.17, 95% confidence interval). Most of the regions presented a stationary trend of cervical cancer deaths. The comparison of regions presenting an increasing trend indicated poorer socioeconomic indices for the former set: regions with an increase in cervical cancer mortality had a significantly higher illiteracy rate (p<0.001), percentage of individuals older than 15 years with less than 4 years schooling (p=0.001), and lower per-capita income (p=0.025) and human development index (p=0.023). An increasing mortality trend was thus observed throughout the State and areas with higher mortality rates had poorer socioeconomic indices.

Objective: describe hospitalizations for ambulatory care sensitive chronic conditions in the state of Paraná, Brazil from 2000 to 2011 method: epidemiological ecological study was to. After descriptive analysis of the data, hospitalization indicators were developed to describe the results.Results: this study's findings suggest that efforts to implement and expand Primary Health Care in Paraná in the last decade resulted in a decrease in the proportion of hospitalizations for ambulatory care sensitive conditions and the average number of hospitalizations for noncommunicable chronic diseases, though the ratio of hospitalizations to resident population has increased. conclusion: attention should be specifically paid to certain causes of hospitalization, such as hypertension and diabetes mellitus, to further minimize hospitalizations for Cerebrovascular Diseases and Congestive Heart Failure, which remained high. método: estudo epidemiológico, do tipo ecológico. Após análise descritiva dos dados, foram elaborados indicadores de internações para descrever os achados da pesquisa. DeScRIPTORSResultados: os esforços para implantação e ampliação da Atenção Primária à Saúde no Paraná, na última década, têm refletido na redução da proporção das internações por causas sensíveis à atenção primária e no número médio de internações por doenças crônicas não transmissíveis. Porém, a razão de internações sofreu um crescimento.conclusão: determinadas causas de internações como a hipertensão e diabetes mellitus devem ser olhadas especificamente na Atenção Primária à Saúde, a fim de minimizar ainda mais as internações por doenças cerebrovasculares e insuficiência cardíaca congestiva, que se mantiveram elevadas. DeScRITOReS:Hospitalização. Estatísticas hospitalares. Sistema de informação hospitalar. Atenção primária à saúde. Doença crônica.

Objective: to check the profile of sensitive causes hospitalizations for primary care. Methods: this is an ecological, epidemiological study. Data was collected in the Hospital Information System at the Department of Health System Information, grouped according to the admissions list for Sensitive to Primary Causes of Health System. Results: there were 227,014 hospitalizations, 25.8% of them were sensitive to Primary care. The illnesses which caused sensitive admissions were pneumonia (n=19,832; 33.7%), heart failure (n=6,688, 11.3%), and gastroenteritis (n=6,287, 10.7%). Conclusion: sensitive hospitalizations for primary care have decreasing historical trend in the study area. Primary care services, with guidelines and principles, well conducted could minimize the risk of exacerbation of chronic conditions and also endorse lower rates of infection transmitted diseases.