No abstract

The northern region of Brazil is already vulnerable to other infectious diseases and it was no different in COVID-19. However, cardiovascular diseases still lead the causes of death. Thus, the objective of this study is to identify the clinical predictors and outcome of severe COVID-19 in hospitalized patients with and without CVD in this region of the Amazon. A retrospective cohort, referring to the notifications from January 1 to December 31, 2020, including cases confirmed by molecular testing. The study consisted of 9223 confirmed cases for COVID-19. Of these, 6011 (65.17%) did not have cardiovascular disease and 3212 (34.83%) had some cardiovascular disease. The significance of deaths was in the age group of < 1 to 59 CVD carriers (< 0.001). Predictor of mortality were invasive ventilation for patients with CVD, (OR 23,688 CI 18,180–30,866), followed by chronic kidney disease (OR 2442 CI 1568–3740), dyspnea (OR 2312 CI 1817–3941), respiratory distress (OR 1523 CI 1210–2919), cough (OR 1268 CI 1005–1599), Lower oxygen saturation 95% (OR 1281 CI 1039–1579), diabetes mellitus (OR 1267 CI 1050–1528) and age (OR 1051 CI 1044–1058). Carriers of CVD had a lower survival rate (< 0.0001). The order of the predictors of death differed among the non-carriers, as well as the high odds ratio in the predictors of CVD, only cough was an independent predictor. The age group under 59 years was associated with deaths. We also show the shorter survival in CVD carriers, as well as the higher cardiovascular morbidity rate than other studies in the literature.

Color vision tests use estimative of threshold color discrimination or number of correct responses to evaluate performance in chromatic discrimination tasks. Both approaches have advantages and disadvantages. In the present investigation, we compared the number of errors during color discrimination task in normal trichromats and participants with color vision deficiency (CVD) using pseudoisochromatic stimuli at fixed saturation levels. We recruited 28 normal trichromats and eight participants with CVD. Cambridge Color Test was used to categorize their color vision phenotype, and those with a phenotype suggestive of color vision deficiency had their L- and M-opsin genes genotyped. Pseudoisochromatic stimuli were shown with target chromaticity in 20 vectors radiating from the background chromaticity and saturation of 0.06, 0.04, 0.03, 0.02, 0.01, and 0.005 u’v' units. Each stimulus condition appeared in four trials. The number of errors for each stimulus condition was considered an indicator of the participant's performance. At high chromatic saturation, there were fewer errors from both phenotypes. The errors of the normal trichromats had no systematic variation for high saturated stimuli, but below 0.02 u’v' units, there was a discrete prevalence of tritan errors. For participants with CVD, the errors happened mainly in red-green chromatic vectors. A three-way ANOVA showed that all factors (color vision phenotype, stimulus saturation, and chromatic vector) had statistically significant effects on the number of errors and that stimulus saturation was the most important main effect. ROC analysis indicated that the performance of the fixed saturation levels to identify CVD was better between 0.02 and 0.06 u’v’ units reaching 100%, while saturation of 0.01 and 0.005 u’v’ units decreased the accuracy of the screening of the test. We concluded that the color discrimination task using high saturated stimuli separated normal trichromats and participants with red-green color vision deficiencies with high performance, which can be considered a promising method for new color vision tests based in frequency of errors.

The surveillance of live births in Brazil has been carried out since 1990 by the Information System on Live Births (SINASC), which was implemented by the Ministry of Health aiming at standardized registration on a national level. The state of Pará is part of the Brazilian Amazon, northern Brazil, which has several unique characteristics. Thus, the purpose of this study was to identify the epidemiological pattern of live births before and during the pandemic of COVID-19 in the state of Pará, 2016 to 2020. This is an ecological epidemiological time-series study, using epidemiological surveillance data from DATASUS, referring to the Live Births Information System (SINASC). These are data that have been treated by surveillance and are in aggregate format. The study population is the live births residing in the state of Pará, in the period from 2016 to 2020. The data collection instrument was the Declaration of Live Births (DLB). There were 689,454 live births, and the highest rates of births were and continued to remain in the Marajó II, Baixo Amazonas, Xingu, and Tapajós regions. The Metropolitan I and Araguaia regions were and continue to be the lowest rates in the state. Age of the mother 15 to 19 years old 22.29%, 20 to 24 years old 30.05% and 25 to 29 years old 22.58%, most of the single pregnancy type 98.32%, prenatal consultations, performed 7 or more 48.10%, followed by 4 to 6 consultations 33.98%, most presented 7 or more years of the study 48.10%, followed by 3 to 6 years 33.98%. Represented 51.21% male and 48.77% female. The occurrence of congenital anomalies represented 0.52% of live births. Another congenital malformation and deformity were the most prevalent at 25.53%, followed by Congenital deformities of the feet 14.90%, Other congenital malformations of the nervous system 14.84%, and Other congenital malformations 10.77%, Cleft lip, and cleft palate 8.88%, Other congenital malformations digestive tract 8.10%. The demographic transition has already occurred for several decades, including the reduction of fertility and birth rate, so our study showed that the reduction in the number of live births was already a reality in the country, but we emphasize that this reduction was enhanced by the pandemic. We observed greater adherence to prenatal care and a lower prevalence of low birth weight compared to other studies, but the limitation was the absence of studies in the same place of the research. Regarding data incompleteness, we emphasize the ignored fields that reflect the fragility in the surveillance of live births, which was reinforced by the literature.

Introduction: Deaths show the epidemiological scenario of the community and allow the planning of effective strategies for the prevention of deaths, mainly by immunopreventable and preventable causes, but for this the surveillance of death must have quality. Epidemiological studies should be carried out periodically to verify the epidemiological pattern of the causes. Objective: To investigate the trends of mortality from leading causes in Brazil from 2011 to 2020. Methodology: Ecological study, with secondary and public data, referring to the national surveillance of deaths. A descriptive and analytical analysis of the deaths per federation unit in Brazil was performed. We contrasted a graph with the six main causes and their trends, which was performed by the R2 equation. We calculated the mortality rate for 2011 and compared it with 2020. We also presented the mortality rates in a choroplectic map. The data were analyzed in Excel 2019, from aggregated data from DATASUS. Results: The period of the study analyzed 12,899,133 million deaths in Brazil, and we highlight the six main causes.: IX Diseases of the circulatory system 3,498,722 (27.12%) upward trend 81%, II Neoplasms (tumors) 2,114,222 (16. 39%) increasing trend 96%, XX External causes of morbidity and mortality 1,512,786 (11.73%), X Respiratory system diseases 1,459,945 (11.52%) increasing trend 71%, IV Endocrine, nutritional and metabolic diseases 786,693 (6.10%) increasing trend 80%. We highlight the highest mortality rates in the federal units in the southeast, south, and northeast of Brazil. Rio de Janeiro had the highest mortality in 2011 611/100,000 inhabitants and also in 2020 785/100,000 inhabitants.  Followed by Rio Grande do Sul in 2011 596/100,000 inhabitants and 2020 650/100,000 inhabitants. Conclusion: We evidenced the tendency of increase in diseases of the circulatory system, respiratory, neoplasms and metabolic endocrine. Highlighting for neoplasms leading all causes, followed by diseases of the circulatory system, which was already known as the leading cause and annual increase. The public policies for the prevention of chronic diseases in Brazil must be strengthened, along with primary health care, to improve the scenario of deaths in Brazil.

The surveillance of live births in Brazil has been carried out since 1990 by the Information System on Live Births (SINASC), which was implemented by the Ministry of Health aiming at standardized registration on a national level. The state of Para is part of the Brazilian Amazon, northern Brazil, which has several unique characteristics. Thus, the purpose of this study was to identify the epidemiological pattern of live births before and during the pandemic of COVID-19 in the state of Para, 2016 to 2020. This is an ecological epidemiological time-series study, using epidemiological surveillance data from DATASUS, referring to the Live Births Information System (SINASC). These are data that have been treated by surveillance and are in aggregate format. The study population is the live births residing in the state of Para, in the period from 2016 to 2020. The data collection instrument was the Declaration of Live Births (DLB). There were 689,454 live births, and the highest rates of births were and continued to remain in the Marajo II, Baixo Amazonas, Xingu, and Tapajos regions. The Metropolitan I and Araguaia regions were and continue to be the lowest rates in the state. Age of the mother 15 to 19 years old 22.29%, 20 to 24 years old 30.05% and 25 to 29 years old 22.58%, most of the single pregnancy type 98.32%, prenatal consultations, performed 7 or more 48.10%, followed by 4 to 6 consultations 33.98%, most presented 7 or more years of the study 48.10%, followed by 3 to 6 years 33.98%. Represented 51.21% male and 48.77% female. The occurrence of congenital anomalies represented 0.52% of live births. Another congenital malformation and deformity were the most prevalent at 25.53%, followed by Congenital deformities of the feet 14.90%, Other congenital malformations of the nervous system 14.84%, and Other congenital malformations 10.77%, Cleft lip, and cleft palate 8.88%, Other congenital malformations digestive tract 8.10%. The demographic transition has already occurred for several decades, including the reduction of fertility and birth rate, so our study showed that the reduction in the number of live births was already a reality in the country, but we emphasize that this reduction was enhanced by the pandemic. We observed greater adherence to prenatal care and a lower prevalence of low birth weight compared to other studies, but the limitation was the absence of studies in the same place of the research. Regarding data incompleteness, we emphasize the ignored fields that reflect the fragility in the surveillance of live births, which was reinforced by the literature.

Mental and behavioral disorders are an important public health problem as a preventable cause in a developing country with great social inequality. The objective of this study was to investigate the causes of death due to mental and behavioral disorders in Brazil from 2011 to 2020 and to analyze the trend of the mortality indicator. It is a cross-sectional and ecological research, with an analytical approach, with public health surveillance data in Brazil. The study analyzed 135,379 deaths from mental and behavioral disorders in Brazil from 2011 to 2020. In the mortality rate, the federation units with the highest rates were Sergipe with 135/100 thousand inhabitants, followed by Minas Gerais 110/100 thousand, Ceará 97 /100 thousand, and Paraná 74/100 thousand. There was a 38% increase in the difference between years, the adherence test was significant 0.0001. The chi- square test was significant by 0.0001, so the male gender is associated with deaths, as well as the young adult age group from 20 to 59, however between 60 and 69 males presented 79% when compared to females, similar to the male gender, is associated with the use of alcohol, multiple drugs, and other psychoactive substances, with the use of cocaine and with the use of tobacco, and with female unspecified dementia, depressive episodes, and vascular dementia. As Brazil is a developing country with great social inequalities, it was to be expected that this cause would be so important in the country. However, public policies should be directed mainly towards the reduction of preventable causes, reducing public spending, and improving the quality of life of the population.