Mortality Trends for Neglected Tropical Diseases in the State of Sergipe, Brazil, 1980-2013.

BACKGROUND: Neglected Tropical Diseases are a set of communicable diseases that affect the population so low socioeconomic status, particularly 1.4 billion people who are living below the poverty level. This study has investigated the magnitude and mortality time trends for these diseases in the state of Sergipe, Northeast Region of Brazil. METHODS: We conducted an ecological study of time series, based on secondary data derived from the Mortality Information System of the Ministry of Health. The mortality rates (crude, age-standardized rates and proportional ratio) were calculated from the deaths due to Neglected Tropical Diseases in the state of Sergipe, from 1980 to 2013. The time trends were obtained using the Joinpoint regression model. RESULTS: Three hundred six thousand and eight hundred seventy-two deaths were certified in the state and Neglected Tropical Diseases were mentioned as the underlying cause in 1,203 certificates (0.39%). Mean number of deaths was 35.38 per year, and crude and age-standardized mortality rates were, respectively: 2.16 per 100 000 inhabitants (95% CI: 1.45-2.87) and 2.87 per 100 000 inhabitants (95% CI: 1.93-3.82); the proportional mortality ratio was 0.41% (95% CI: 0.27-0.54). In that period, Schistosomiasis caused 654 deaths (54.36%), followed by Chagas disease, with 211 (17.54%), and by Leishmaniases, with 142 (11.80%) deaths. The other diseases totalized 196 deaths (16.30%). There were increasing mortality trends for Neglected Tropical Diseases, Schistosomiasis and Chagas disease in the last 15 years, according to the age-standardized rates, and stability of the mortality trends for Leishmaniases. CONCLUSIONS: The Neglected Tropical Diseases show increasing trends and are a real public health problem in the state of Sergipe, since they are responsible for significant mortality rates. The following diseases call attention for showing greater number of deaths in the period of study: Schistosomiasis, Chagas disease and Leishmaniases. We finally suggest that public managers take appropriate actions to develop new strategies in epidemiological and therapeutic surveillance, and in the follow-up of these patients.

Spinal block for urgency orthopedic surgery in Von Recklinghausen's disease patient. Case report.

BACKGROUND AND OBJECTIVES: Von Recklinghausen's disease is a neurogenetic disease due to chromosome 17 abnormality. This report aimed at describing the anesthetic approach for Von Recklinghausen's disease patient submitted to urgency orthopedic surgery. CASE REPORT: Female patient, 28 years old, with Von Recklinghausen's disease, submitted to emergency orthopedic surgery under spinal block. There have been no complications both in the intraoperative period and in the post-anesthetic care unit. Patient was discharged 4 days later. CONCLUSIONS: Spinal block was possible in this case with no need for airway handling.

Raquianestesia para cirurgia ortopédica de urgência em paciente portadora de doença de Von Recklinghausen: relato de caso / Spinal anesthesia for emergency orthopedic surgery in a patient with Von Recklinghausen disease: case report

JUSTIFICATIVA E OBJETIVOS: A doença de Von Recklinghausen é uma doença neurogenética causada por uma anomalia no cromossomo 17. O objetivo deste relato foi descrever a conduta anestésica em paciente com doença de Von Recklinghausen submetida à cirurgia ortopédica de urgência. RELATO DO CASO: Paciente do sexo feminino, 28 anos, portadora da doença de Von Recklinghausen, submetida à cirurgia ortopédica em hospital de emergência sob raquianestesia. Não apresentou complicações no período intra-operatório, nem na sala de recuperação pós-anestésica. Teve alta hospitalar no 4° dia de pós-operatório. CONCLUSÕES: No caso relatado foi possível a realização da raquianestesia sem haver necessidade de manuseio da via aérea.

A lesäo apical na miocardiopatia chagásica / Apical lesion in chagasic myocardiopathy

Os autores realizam revisäo, assim como relatam sua experiência, com o estudo de nove casos, da chamada Lesäo Apical na Miocardiopatia Chagásica. Salientam a frequência, patogenia, aspectos clínicos, diagnóstico e tratamento dessa entidade, de ocorrência comum em nosso meio