Dementia is characterized by deficits in more than one cognitive domain,
affecting language, praxis, gnosis, memory or executive functions. Despite the
essential economic growth observed in many developing countries, especially over
the last century, huge differences remain in health care, whether among nations
themselves or across different regions of the same country.ObjectiveThe aim of this study was to assess the management and main features of
dementia, comparing public (PUBL) and private (PRIV) reference services.MethodsWe performed a retrospective analysis of medical records of subjects with
dementia. Sociocultural data, mean follow-up time in the service,
Mini-mental State Examination (MMSE) scores at admission, main diagnosis of
dementia, family history of dementia, comorbidities, imaging methods and
treatment were assessed.Resultsthe time elapsed before admission in the service of the PUBL group
(2.08±2.06 years) was higher than for the PRIV group
(1.24±2.55 years) (p=0.0356); the MMSE score at admission in the PUBL
group (15.05±8.16 years) was lower than in the PRIV group
(18.95±6.69 years) (p=0.016); the PUBL group showed lower treatment
coverage with cholinesterase inhibitors (52.94%) than the PRIV group
(84.93%) (p=0.0001).ConclusionPatients seeking the public health service have less access to medical care,
reaching the system at more advanced stages of disease. The public service
also offered lower pharmacological coverage.
BACKGROUND Adult-onset Still Disease (AOSD) is a chronic inflammatory disease of unknown etiology that commonly affects young adults. Treatment of AOSD patients includes non-steroidal anti-inflammatory drugs, corticosteroids and disease-modifying antirheumatic drugs (Methotrexate, Leflunomide, Azathioprine, Cyclosporine, Cyclophosphamide). And, recently, biological drugs such as anti-IL1, anti-TNF and anti-IL6 are being included as a treatment option.
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