Introdução: A diarreia é um dos sinais mais antigos já descritos, atinge todas as faixas etárias, ricos e pobres, países desenvolvidos e em desenvolvimento apresentando significante relação com a pobreza. Está relacionada à elevada morbidade e mortalidade, sendo o seu manejo fundamental para melhora de indicadores sociais. Objetivo: O presente estudo analisou a evolução das taxas de hospitalização e as taxas de mortalidade por diarreia no Brasil durante os anos de 2000 a 2015. Materiais e Métodos: Foi realizado um estudo de agregado temporal, retrospectivo e descritivo de 15 anos (2000 a 2015), utilizando as taxas de mortalidade e de internação hospitalar de diarreia nos 26 estados federais e no Distrito Federal. Os dados foram extraídos do DATASUS e IBGE. Resultados: No período analisado observou-se mais de 3,4 milhões de casos de internações hospitalares por diarreia e 72 mil mortes no território brasileiro. A taxa média de internação foi de 112/100 mil habitantes (IC95%, 100-123). As maiores taxas de mortalidade foram em pacientes acima de 80 anos, com 49/100 mil habitantes (IC95%, 47-52). Observou-se ao longo dos anos uma melhora nos índices pediátricos, porém foi notado aumento da mortalidade e internação hospitalar em estados do Nordeste na população idosa. Conclusão: O Brasil apresentou melhora nos índices de internação e mortalidade por doença diarreica em um contexto geral, possivelmente devido a melhora da infraestrutura social e do tratamento hospitalar, no entanto, cuidados com a população idosa ainda merecem atenção especial principalmente no Nordeste. Contudo, investimentos ainda devem ser feitos para consolidar esse cenário.
Knowledge of the hepatic arterial anatomy and celiac trunk is gaining importance, since the use of minimally invasive surgeries is more frequent nowadays. This kind of procedure meant that surgeons had less room for visualization of anatomical variants and work. In addition, failure to recognize the correct anatomy of the hepatic vascularization in a transplant procedure can lead to organ failure and death. The present case aims to demonstrate an arterial hepatic celiac trunk pattern that was never described by any of the acknowledged classification systems. This pattern is challenging for the surgical management of possible upper abdominal interventions, since non-recognition may lead to iatrogenesis.
Introdução: Sistemas de inteligência artificial são tecnologias promissoras de assistência em saúde e diagnóstico laboratorial, que podem ser implementados como métodos de suporte para o diagnóstico de parasitoses intestinais. Este estudo objetivou desenvolver um software de IA que auxilia no diagnóstico laboratorial de parasitoses intestinais, com alta sensibilidade e especificidade. Métodos: O software foi desenvolvido utilizando duas redes neurais, Inception e MobileNet. Primeiro imagens de ovos dos parasitas Ascaris lumbricoides, Trichiuris trichiura, Taenia sp, Hymenolepis nana, Schistosoma mansoni e larvas de Strongyloides stercoralis, foram utilizados para treinar o banco de dados. Posteriormente 2.740 imagens cedidas pelo Laboratório de Parasitologia da Universidade do Oeste de Santa Catarina foram testadas no software.Resultados: O software apresentou sensibilidade de 82,3% (95% intervalo de confiança (IC), 71,9%-89,1%) e especificidade de 95,1% (95% IC, 94,3%-97,8%) para MobileNet e sensibilidade de 72,1% (95% IC, 52,6%-115%) e especificidade de 92,1% (95% IC, 91,7%-97,7%) para Inception.Conclusão: O software apresentou resultados promissores na análise de parasitas intestinais, reforçando que, no futuro, a presença de sistemas de suporte de diagnóstico das parasitoses pode vir a se tornar mais rápido e eficiente.
The history of muscle biopsy dates back to 1860, when Duchenne first performed a biopsy on a patient with symptoms of myopathy (1) . Since then, the basic and clinical science of muscle and muscle disease has gone through three stages of development: the classical period, the modern stage and the molecular era.
Introduction: Viral hepatitis is a group of diseases that present high hepatotropism and are related to liver dysfunctions, having either an acute or a chronic course. Their worldwide epidemiology is diverse, with several endemic places, such as South America. The objective of this study was to analyze the epidemiology of viral hepatitis in Brazil, in order to better understand its pattern of distribution and evolution. Method: A temporal aggregation study was conducted using the Viral Hepatitis Database of the Brazilian Ministry of Health. The serological markers used were HBsAg and anti-HCV for hepatitis B and C, respectively. Mortality data were collected from the Mortality Information System for deaths attributed to viral hepatitis. The period analyzed was from 2007 to 2016/17. Results: The incidence was 7.88 (95% CI, 7.30-8.45) for hepatitis B and 11.9 (95% CI, 11.15-12.65) for hepatitis C. Mortality attributed to viral hepatitis was 1.61 (95% CI, 1.35-1.87) deaths per 100,000 people. An analysis of municipal distribution data showed several endemic areas. The Brazilian regions most affected by hepatitis B virus were the northern and southern borders, Santa Catarina coast and Espírito Santo state, while hepatitis C virus was mostly present in metropolitan areas such as Porto Alegre and São Paulo. Conclusions: Viral hepatitis has a diverse geographic distribution in the Brazilian territory, with highly endemic areas. The distribution differs between hepatitis B and hepatitis C viruses.
Cervical neoplasia has high morbidity and mortality and is the main female gynecological neoplasia, but it is susceptible to early detection and cure. A major challenge for developing countries such as Brazil is the expansion of prevention programs, which becomes more effective when the epidemiology is known. The objective of this study was to conduct an epidemiological survey to evaluate the Brazilian panorama of this neoplasm. A temporal aggregate study was performed using the mortality and hospital admission rates for cervical neoplasia throughout the Brazilian territory during the years 2005 to 2015, data obtained through DATASUS and IBGE. During the years 2005 to 2015, there was a significant drop (p<0.05) in hospital admission rates in the 0-19, 20-39, 40-59, 60-79 years, with an average fall of 36 % and a death increase in the age group 20-39 years. The North region had a significant increase in death in the range ≥ 80 years, 140%, p<0.02. The mean mortality rate in Brazil was 5.14, with a 95% CI of 5.01 to 5.27. Cervical neoplasia is still present in Brazil, although mortality has a tendency to decrease, this tendency is unequally distributed in Brazil, with the north and northeast regions showing the highest rates. Better public policies are fundamental.
Introduction: Cutaneous neoplasms are the most common cancers in the world, and have high morbidity rates. A definitive diagnosis can only be obtained after histopathological evaluation of the lesions. To develop an artificial intelligence program to establish the histopathological diagnosis of cutaneous lesions.Methods: A deep learning program was built using three neural network architectures: MobileNet, Inception and convolutional networks. A database was constructed using 2732 images of melanomas, basal and squamous cell carcinomas, and normal skin. The validation set consisted of 284 images from all 4 categories, allowing for the calculation of sensitivity and specificity. All images were provided by the Path Presenter website. Results:The sensitivity and specificity of the MobileNet model were 92% (95%CI, 83-100%) and 97% (95%CI, 90-100%), respectively; corresponding figures for the Inception model were 98.3% (95%CI, 86-100%) and 98.8% (95%CI, 98.2-100%); lastly, the sensitivity and specificity of the convolutional network model were 91.6% (95%CI, 73.8-100%) and 95.7% (95%CI, 94.4-97.2%). The maximum sensitivity for the differentiation of malignant conditions was 91%, and specificity was 95.4%. Conclusion:The program developed in the present study can efficiently distinguish between the main types of skin cancer with high sensitivity and specificity.
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