Increase of Stroke Incidence in Young Adults in a Middle-Income Country: A 10-Year Population-Based Study.

BACKGROUND AND PURPOSE: The incidence of stroke is on the rise in young adults in high-income countries. However, there is a gap of knowledge about trends in stroke incidence in young adults from low- and middle-income countries. We aimed to measure trends in incidence of ischemic stroke (IS) and intracerebral hemorrhage (IH) in young people from 2005 to 2015 in Joinville, Brazil. METHODS: We retrospectively ascertained all first-ever IS subtypes and IH that occurred in Joinville in the periods of 2005 to 2006, 2010 to 2011, and 2014 to 2015. Poisson regression was used to calculate incidence rate ratios of all strokes, IS, and IH. We also compared the prevalence of risk factors and extension of diagnostic work-up across the 3 periods. RESULTS: For 10 years, we registered 2483 patients (7.5% aged <45 years). From 2005 to 2006 to 2014 to 2015, overall stroke incidence significantly increased by 62% (incidence rate ratios, 1.62; 95% confidence interval, 1.10-2.40) in subjects <45 years and by 29% in those <55 years (incidence rate ratios, 1.29; 95% confidence interval, 1.04-1.60). Incidence of IS increased by 66% (incidence rate ratios, 1.66; 95% confidence interval, 1.09-2.54), but there was no significant change in incidence of IH in subjects <45 years. Smoking rates decreased by 71% (odds ratio, 0.29; 95% confidence interval, 0.12-0.68). CONCLUSIONS: Stroke incidence is rising in young adults in Joinville, Brazil, because of increase in rates of ischemic but not hemorrhagic strokes. We urgently need better policies of cardiovascular prevention in the young.

[Study on the adverse effects and protective effects of influenza vaccine among elderly individuals vaccinated through the public system in the municipality of Tubarão, State of Santa Catarina]. / Estudo dos efeitos adversos e do efeito protetor da vacina contra influenza em idosos vacinados pela rede pública no município de Tubarão, Estado de Santa Catarina.

INTRODUCTION: The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina. METHODS: A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups. RESULTS: It was observed that 22.5% of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47% and 28.8% (RR = 1.11; 1.02-1.22; p = 0.0156), respectively. CONCLUSIONS: These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.

Estudo dos efeitos adversos e do efeito protetor da vacina contra influenza em idosos vacinados pela rede pública no município de Tubarão, Estado de Santa Catarina / Study on the adverse effects and protective effects of influenza vaccine among elderly individuals vaccinated through the public system in the municipality of Tubarão, State of Santa Catarina

INTRODUÇÃO: O presente estudo buscou identificar os efeitos adversos e o efeito protetor da vacina contra influenza, em idosos acima de 60 anos, aplicada pela rede pública no município de Tubarão, Santa Catarina. MÉTODOS: Foi realizada uma coorte prospectiva de pacientes durante o período de maio a setembro de 2008. Foram recrutados 341 idosos, sendo 289 vacinados na rede pública (VSUS) e 52 não vacinados (NV). A incidência do efeito protetor foi verificada através da comparação dos grupos VSUS com os NV. RESULTADOS: Um percentual de 22,5 por cento de pacientes apresentou pelo menos um efeito adverso. Comparando o grupo VSUS e NV quanto à incidência de sintomas gripais durante o inverno, a presença de pelo menos um sintoma foi verificada em 47 por cento e 28,8 por cento (RR = 1,11; 1,02-1,22; p = 0,0156), respectivamente. CONCLUSÕES: Os resultados apontam uma baixa incidência de efeitos adversos. A maior incidência de sintomas gripais no grupo VSUS comparado ao NV pode estar relacionado às características da população que costuma fazer a vacina contra influenza.

INTRODUCTION: The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina. METHODS: A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups. RESULTS: It was observed that 22.5 percent of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47 percent and 28.8 percent (RR = 1.11; 1.02-1.22; p = 0.0156), respectively. CONCLUSIONS: These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.