RESUMO
OBJECTIVES: We compared the incidence of recurrent or fatal cardiovascular disease in patients using Brazil's government-run Family Health Program (FHP) with those using non-FHP models of care. METHODS: From 2005 to 2010, we followed outpatients discharged from city public hospitals after a first ever stroke for stroke recurrence and myocardial infarction, using data from all city hospitals, death certificates, and outpatient monitoring in state-run and private units. RESULTS: In the follow-up period, 103 patients in the FHP units and 138 in the non-FHP units had exclusively state-run care. Stroke or myocardial infarction occurred in 30.1% of patients in the FHP group and 36.2% of patients in non-FHP care (rate ratio [RR] = 0.85; 95% confidence interval [CI] = 0.61, 1.18; P = .39); 37.9% of patients in FHP care and 54.3% in non-FHP care (RR = 0.68; 95% CI = 0.50, 0.92; P = .01) died. FHP use was associated with lower hazard of death from all causes (hazard ratio [HR] = 0.58; P = .005) after adjusting for age and stroke severity. The absolute risk reduction for death by all causes was 16.4%. CONCLUSIONS: FHP care is more effective than is non-FHP care at preventing death from secondary stroke and myocardial infarction.
Assuntos
Infarto do Miocárdio/prevenção & controle , Programas Nacionais de Saúde/estatística & dados numéricos , Acidente Vascular Cerebral/prevenção & controle , Idoso , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/mortalidade , Avaliação de Programas e Projetos de Saúde , Modelos de Riscos Proporcionais , Análise de Regressão , Fatores de Risco , Prevenção Secundária , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/mortalidadeRESUMO
In addition to the famous sign described by Joseph Babinski, which is also known as Babinski's reflex, there are references in the literature to various other signs described by this famous disciple of J-M Charcot. This article reviews all the neurological signs described by Babinski.
Assuntos
Neurologia/história , Reflexo de Babinski/história , França , História do Século XIX , História do Século XX , PolôniaRESUMO
In addition to the famous sign described by Joseph Babinski, which is also known as Babinski's reflex, there are references in the literature to various other signs described by this famous disciple of J-M Charcot. This article reviews all the neurological signs described by Babinski.
Além do famoso sinal descrito por Joseph Babinski, também definido como reflexo de Babinski, existem referências na literatura mundial de vários outros sinais descritos pelo famoso discípulo de J-M Charcot. Este artigo apresenta uma revisão de todos os sinais neurológicos descritos pelo professor Babinski.