Objectives
Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs.
Methods
This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017–2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis.
Results
From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget.
Conclusion
The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.
Objetivo: Avaliar a capacidade institucional dos serviços de saúde na percepção dos profissionais no contexto da implantação do Modelo de Atenção às Condições Crônicas explorando as diferenças entre as unidades básicas de saúde. Métodos: Trata-se de um estudo de painel com avaliação antes (2013), durante (2015) e após (2018) a implantação do Modelo de Atenção às Condições Crônicas (MACC) no sistema de saúde com foco em três condições crônicas: Diabetes Mellitus, Hipertensão e gestantes. Nos três momentos, os profissionais de saúde das unidades da atenção primária e especializada avaliaram a capacidade institucional por meio do instrumento Assessment of Chronic Illness Care (ACIC). Resultados: Após a implantação do MACC observa-se um aumento estatisticamente significativo dos escores do ACIC para todas as dimensões em todas unidades de saúde. Conclusão: Na avaliação dos profissionais foi evidenciado ganho importante na capacidade institucional do município para o cuidado das condições crônicas após intervenção no sistema de saúde.
Introdução: nos dias atuais, a obesidade tornou-se um problema de saúde pública em escala global. Entre os tratamentos disponíveis, destaca-se o uso da sibutramina. Entretanto, este fármaco apresentou diversos efeitos adversos (EA), sendo os de maior relevância os cardiovasculares. Objetivo: o objetivo deste estudo foi avaliar se a terapia com a sibutramina traz malefícios à saúde humana. Métodos: a revisão sistemática foi realizada seguindo o protocolo PRISMA para revisões sistemáticas e utilizando as bases de dados PubMed, LILACS e SciElo. Nestas, buscaram-se estudos publicados entre 2006 e 2016, utilizando-se dos descritores “sibutramine” e “adverse effects” junto com o operador booleano “AND”. Resultados: dezoito artigos, das 479 publicações encontradas, atenderam aos critérios de inclusão, sendo, então, utilizados para compor a presente revisão. Os EA mais encontrados foram complicações cardiocirculatórias (66,6%), sendo as mais frequentes a taquicardia e a hipertensão arterial sistêmica (HAS). Adicionalmente a esses, a constipação intestinal e a boca seca/xerostomia (55,5%), cefaleia e insônia (38,8%) e alterações de humor (26,6%) também foram relatados. Além disso, o tratamento com sibutramina mostrou-se eficaz na perda de peso em 88,88% dos estudos analisados. Conclusão: apesar da terapêutica com sibutramina ter apresentado efetividade na redução de peso, não se pode concluir acerca da segurança desse fármaco.
Chagas disease (CD) is a neglected tropical highly morbid disease that can have a
negative impact on the quality of life (QoL). The purpose of this study was to
conduct an integrative review to analyze the QoL of patients with CD in the
chronic phase of the disease, as well as the instruments used and the effect of
different interventions. The review was carried out based on the criteria and
recommendations of the Preferred Reporting Items for Systematic Reviews and
Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and
Science Direct databases. An analysis of the reference list of the included
articles was also carried out. Publications in all languages have been included.
Two independent reviewers selected the eligible articles and extracted the data.
A total of 1,479 articles were identified, and after applying the inclusion
criteria 18 articles were included. Four different instruments were used to
assess QoL and the most used was the Minnesota Living with Heart Failure
Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention
showed a positive impact on the patients’ QoL, and the Environment domain had
the lowest score. Heterogeneity of instruments and lack of methodology
standardization for assessing QoL was observed. QoL proved to be an important
indicator for the planning and monitoring of patients with CD, however it is
suggested that the instruments for its assessment should be the ones recommended
by the validation studies. This process will allow the comparison of data
between investigations.
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