HighlightsThe schwannoma of the esophagus is a rare case report.We present a review of the main characteristics of this disease.Aspects covered epidemiological, clinical, surgical, histopathological and immunohistochemical.
ResumoObjetivo: O objetivo deste estudo foi contribuir para o entendimento de algumas questões de saúde perinatal e do componente neonatal da mortalidade infantil, através da elaboração dos indicadores para a área perinatal e a do estudo de aspectos da qualidade da atenção à saúde oferecida à mulher grávida e seu filho recém-nascido. Em particular, estimou-se a proporção de mortes perinatais evitáveis no município de Fortaleza, Ceará.Metodologia: Estudo prospectivo de incidência com base populacional. Realizado a partir da coleta de dados em 17 maternidades públicas ou conveniadas e dois hospitais pediátricos de referên-cia do sistema único de saúde do município de Fortaleza. Foram estudadas todas as crianças nascidas vivas ou mortas com peso igual ou superior a 500 gramas no ano de 1995. As causas de mortes perinatais foram estudadas segundo a classificação de Wigglesworth modificada (1989).Resultados: Nasceram no período estudado 40.712 crianças e ocorreram 1.337 mortes perinatais -730 no período fetal e 607 na primeira semana de vida. Apesar da baixa prevalência de recém-nascidos com baixo peso (7,4%), foram elevados os coeficientes de mortalidade fetal (17,9‰), perinatal (32,8‰) e neonatal precoce (15,1‰). O número de óbitos perinatais redutíveis por adequada atenção perinatal foi estimado em pelo menos um terço do total dos óbitos estudados (458/1.323). Conclusões:Os resultados encontrados evidenciam uma situação de saúde perinatal bastante precária, com possíveis problemas na organização do sistema e na qualidade da atenção à saúde prestada às gestantes durante o pré-natal e o parto e no atendimento aos recém-nascidos em sala de parto e bercário.J. pediatr. (Rio J.). 1997; 73(6):388-394: mortalidade perinatal, qualidade dos cuidados de saúde, peso ao nascer. AbstractObjective: The main objective of this study was to explore the relationship between perinatal care and neonatal mortality as a component of the infant mortality. Indicators were selected to analyze some aspects of the quality of perinatal care attendance offered to pregnant women and their newborns. Specific attention was given to the avoidable perinatal deaths in the city of Fortaleza, Ceará.Methods: Population-based, prospective study on incidence. The study was carried out collecting data of seventeen maternity units and two referral pediatric hospitals of the public health system in Fortaleza, the capital of the State of Ceará. All births, alive or dead, weighting 500 grams or more, along the whole year of 1995, were included in the study. The perinatal deaths' causes were studied according to the modified Wigglesworth classification (1989).Results: Along the whole study period, 40,712 children were born and 1,337 perinatal deaths occurred. Among them 730 occurred during the fetal life and 607 during the first week of life. In spite of the low incidence of low-weight newborns (7.4%), the coefficients of fetal mortality were high (17.9‰), as well as the perinatal mortality (32.8‰) and neonatal mortality (15.1‰). The number of avoidable perin...
Background Vaccinations have long been considered to be possible triggering agents for chronic arthritis, but no sufficiently definitive epidemiological study has been published on this issue. There are case reports of chronic arthropathy presumably induced by rubella, meales and mumps vaccination (MMR), but controlled studies have failed to establish this association Objectives The aim of the present prospective cohort study was to investigate the association of MMR vaccination and the onset of acute or chronic articular symptom in healthy subjects Methods In Brazil, two prospective cohorts studies taken place during two National immunization campaign: first in 2008 against rubella to reach subjects aged 20-40 years and another in 2011 against measles to reach children aged 1-7 years. In both the vaccine used was MMR. In our city the target was the coverage of 9,000 people to be vaccinated in these age groups, including both males and females. Among those, near 2,000 subjects were randomly selected. Follow-up telephone calls were conducted 2 weeks post vaccination and subsequently monthly after the vaccination over a 6 month period, in order to inquire about occurrence and duration of articular symptoms. In cases where the subjects circumstances were unclear a medical visit was scheduled. Subjects with a preexisting autoimmune disease were excluded from the study Results Of the 2,000 selected vaccinated subjects, 972 adults and 827 children have completed the follow up period of 6 months. The vaccine was the first dose for 543 subjects (55%) in the adult group and for 672 children (81%). At the time of the first phone call 17/972 (1.7%) adults subjects and 14/827 (1,7%) childhood age group reported acute articular symptoms: twelve reported arthralgia and five arthritis with all of them being fleeting, lasting no longer than 7 days; eleven were female and six male (p=0.5); twelve had received their first dose of RV and the remaining five following a booster (p=1,0). For the childhood group the rate of acute articular symptoms in the first evaluation was the same 1,7% (14/827), among of them 4 had arthritis and only in two lasting one month; in 13/14 had received their first dose of RV and in only one was a booster (p=0,71). None in the both groups had a chronic outcome. Conclusions In our study, which comprised a large number of healthy subjects in different age groups, rubella vaccination was safe and was not associated with the development of chronic arthritis. These findings should be spread among public healthcare providers in order to encourage vaccinations in accordance with recommended national vaccination schedules. Disclosure of Interest None Declared
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