RESUMO
O impacto que a neoplasia maligna do colo do útero tem na população mundial e em políticas públicas é notório. Vide a importância do assunto, o objetivo deste artigo é analisar o número de óbitos por neoplasia maligna do colo do útero segundo local de residência, local de internação e faixa etária, no período de 2013 a 2022 registrados no Sistema de Informações Hospitalares do SUS - SIH/SUS. Trata-se de um estudo descritivo transversal. A coleta de dados foi realizada em Sistemas de Informação hospedados no DATASUS/TABNET. Os resultados revelaram uma discrepância no número de óbitos nos estados brasileiros quando comparados o local de internação e o local de residência. A faixa etária com maior número de óbitos foi registrada dos 50 a 54 anos; tendo a pandemia da COVID-19 impactado na redução dos registros nos anos de 2020 e 2021. Conclui-se que a neoplasia maligna do colo do útero representa um desafio para a saúde pública no Brasil, com aumento do número de óbitos registrados ao longo dos anos, embora isso possa ser influenciado por fatores como densidade populacional e qualidade dos registros. Observou-se disparidade entre óbitos por internação e óbitos por residência entre estados, indicando a necessidade de estratégias específicas de prevenção e controle, além de análises mais abrangentes considerando outras fontes de informação e fatores contribuintes para essas diferenças.
The impact of malignant cervical neoplasms on the global population and public policies is notable. Given the importance of this issue, the objective of this article is to analyze the number of deaths from malignant cervical neoplasms by place of residence and place of hospitalization and age group during the period from 2013 to 2022, as recorded in the Hospital Information System of SUS (SIH/SUS). This is a descriptive cross-sectional study. Data collection was performed using Information Systems hosted on DATASUS/TABNET. The results revealed discrepancies in the number of deaths across Brazilian states when comparing the place of hospitalization and place of residence. The age group with the highest number of deaths was recorded from 50 to 54 years; the COVID-19 pandemic impacted the reduction in records in 2020 and 2021. It is concluded that malignant cervical neoplasm represents a challenge for public health in Brazil, with an increase in the number of deaths recorded over the years, although this may be influenced by factors such as population density and the quality of records. Disparities between deaths by hospitalization and deaths by residence among states were observed, indicating the need for specific prevention and control strategies, as well as more comprehensive analyses considering other sources of information and contributing factors to these differences.
RESUMO
Abstract Clinical pharmacists have been increasing their participation mainly through actions aimed at patient care, with international studies demonstrating favorable cost-benefit ratio from pharmacists interventions. However, there are few studies carried out in Brazil about the subject. This study aims to assess the economic impact of pharmaceutical interventions (PIs) in a hospital setting performed in October 2018. Each performed PI was registered and associated with the direct cost of drugs for economic impact analysis. A total of 185 PIs were evaluated, comprising 106 patients. The most intervened drugs were antibiotics, presenting the greatest economic impact, R$2,370. The total economic impact was R$2,578, mainly in the Pediatric Intensive Care Unit that represented R$1,701. Regarding the economic impact by PI as the "Suspension of drug without indication" saved R$1,360 while the "Inclusion of required drugs" cost R$807. It was estimated that the savings would be R$30,936 and, if PIs were performed at day zero, the savings would be R$79,728 per year. An average of 1.75 PI per patient was performed with an economic impact of R$14 per PI. Our results showed that clinical pharmacist's role in the evaluation of pharmacotherapy is important for patients' health and represents a positive economic impact.
RESUMO
Clostridioides difficile is an important organism causing healthcare-associated infections. It has been documented that specific strains caused multiple outbreaks globally, and patients infected with those strains are more likely to develop severe C. difficile infection (CDI). With the appearance of a variant strain, BI/NAP1 ribotype 027, responsible for several outbreaks and high mortality rates worldwide, the epidemiology of the CDI changed drastically in the United States, Europe, and some Latin American countries. Although the epidemic strain 027 was not yet detected in Brazil, there are ribotypes exclusively found in the country, such as, 131, 132, 133, 135, 142 and 143, which are responsible for outbreaks in Brazilian hospitals and nursing homes. Although PCR-ribotyping is the most used method in epidemiology studies of C. difficile, it is not available in Brazil. This study aimed to develop and validate an in-house database for detecting C. difficile ribotypes, usually involved in CDI in Brazilian hospitals, by using MALDI-TOF MS. A database with 19 different ribotypes, 13 with worldwide circulation and 6 Brazilian-restricted, was created based on 27 spectra readings of each ribotype. After BioNumerics analysis, neighbor-joining trees revealed that spectra were distributed in clusters according to ribotypes, showing that MALDI-TOF MS could discriminate all 19 ribotypes. Moreover, each ribotype showed a different profile with 42 biomarkers detected in total. Based on their intensity and occurrence, 13 biomarkers were chosen to compose ribotype-specific profiles, and in silico analysis showed that most of these biomarkers were uncharacterized proteins or well-conserved peptides, such as ribosomal proteins. A double-blind assessment using the 13 biomarkers correctly assigned the ribotype in 73% of the spectra analyzed, with 94%-100% of correct hits for 027 and for Brazilian ribotypes. Although further analyses are required, our results show that MALDI-TOF MS might be a reliable, fast and feasible alternative for epidemiological surveillance of C. difficile in Brazil.
