Epidemiology of urolithiasis consultations in the Paraíba Valley / Epidemiologia dos atendimentos por urolitíase no Vale do Paraíba

ABSTRACT Objective: to know the epidemiological profile of patients with urolithiasis in the Paraíba Valley region, identifying its prevalence and spatial distribution. Method: we conducted a cross-sectional study, by residence location in the Paraíba Valley, on morbidity data due to urolithiasis obtained from the DATASUS, covering the period between 2010 and 2012. We aimed at identifying the general, male and female prevalence of urolithiasis, the distribution by age, type of visit, year season and spatial distribution. Results: there were 1,901 visits for urolithiasis in the 35 municipalities of the Paraíba Valley in the three years studied, 52.3% of them of female patients. Of the total, 70.1% of the visits were emergency ones. The feminine visits (67.2%) were mostly also urgent (p <0.01). The overall prevalence for urolithiasis was 31.7/100,000. Male prevalence was 30.7/100,000, and the female, 32.7/100,000 (p>0.05). The prevalence ratio was 0.9 men for every woman. The age group with the highest prevalence was between 30 and 39 years, with 23.1%. Warm seasons concentrated 51.6% of cases, while 48.8% occurred in the cold ones (p>0.05) . Conclusion: women are more affected by urolithiasis than the male in the Paraíba Valley region, an unprecedented in the literature. There was no relationship between the year season and the disease. We identified municipalities where preventive actions of urinary lithogenesis are required.

RESUMO Objetivo: conhecer o perfil epidemiológico dos pacientes com urolitíase, na região do Vale do Paraíba, identificando sua prevalência e distribuição espacial. Métodos: estudo transversal com dados de morbidade por local de residência decorrente de urolitíase no Vale do Paraíba, relativos ao período compreendido entre 2010 e 2012, obtidos do DATASUS. Os dados foram analisados para identificar a prevalência geral, masculina e feminina da urolitíase, a distribuição por idade, tipo de atendimento, estação do ano e sua distribuição espacial. Resultados: ocorreram 1901 atendimentos por urolitíase nos 35 municípios do Vale do Paraíba nos três anos estudados, sendo 52,3% dos pacientes do sexo feminino. Do total, 70,1% dos atendimentos foram em caráter de urgência. Os atendimentos femininos, na sua maioria (67,2%), também foram de urgência (p<0,01). A prevalência geral encontrada para a urolitíase foi 31,7/100.000 habitantes. A prevalência masculina foi 30,7/100.000 e a feminina de 32,7/100.000 (p>0,05). A relação de prevalência encontrada foi 0,9 homens para cada mulher. A faixa etária com o maior número de pacientes atendidos foi entre 30 e 39 anos, com 23,1% do total. Nas estações quentes ocorreram 51,6% dos atendimentos, enquanto nas frias 48,8% (p>0,05). Conclusões: foi possível identificar que na região do Vale do Paraíba o sexo feminino é mais acometido pela urolitíase do que o masculino, fato inédito na literatura. Não se encontrou relação entre a estação do ano e a doença. Foram identificados municípios onde ações de prevenção da litogênese urinária são necessárias.

Epidemiology of urolithiasis consultations in the Paraíba Valley.

OBJECTIVE: to know the epidemiological profile of patients with urolithiasis in the Paraíba Valley region, identifying its prevalence and spatial distribution. METHOD: we conducted a cross-sectional study, by residence location in the Paraíba Valley, on morbidity data due to urolithiasis obtained from the DATASUS, covering the period between 2010 and 2012. We aimed at identifying the general, male and female prevalence of urolithiasis, the distribution by age, type of visit, year season and spatial distribution. RESULTS: there were 1,901 visits for urolithiasis in the 35 municipalities of the Paraíba Valley in the three years studied, 52.3% of them of female patients. Of the total, 70.1% of the visits were emergency ones. The feminine visits (67.2%) were mostly also urgent (p <0.01). The overall prevalence for urolithiasis was 31.7/100,000. Male prevalence was 30.7/100,000, and the female, 32.7/100,000 (p>0.05). The prevalence ratio was 0.9 men for every woman. The age group with the highest prevalence was between 30 and 39 years, with 23.1%. Warm seasons concentrated 51.6% of cases, while 48.8% occurred in the cold ones (p>0.05) . CONCLUSION: women are more affected by urolithiasis than the male in the Paraíba Valley region, an unprecedented in the literature. There was no relationship between the year season and the disease. We identified municipalities where preventive actions of urinary lithogenesis are required.

Pulmonary Vein Stenosis in a Newborn: A Commonly Overlooked Diagnosis.

The diagnosis of primary pulmonary vein stenosis is often overlooked because its symptoms overlap lung diseases and pulmonary arterial hypertension. Its diagnosis may be difficult because the condition is progressive and associated with other defects. We present a case of pulmonary vein stenosis in a newborn with stenosis of the left-sided common pulmonary vein, diffuse hypoplasia of the superior right pulmonary vein, and atresia of the inferior right pulmonary vein.

Aneurysm of the Left Coronary Artery in Postoperative Bland-White-Garland Syndrome.

We report a case of anomalous left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome, present the challenges of performing a differential diagnosis, and discuss the treatment of the syndrome. Although ALCAPA is a rare congenital heart disease, it is one of the most common causes of myocardial ischemia in childhood and presents a diagnostic challenge. A four-year-old girl was referred to a pediatric cardiologist for evaluation of mitral valve regurgitation murmur and heart failure. The transthoracic echocardiogram demonstrated the left coronary artery (LCA) not arising from the aorta, presence of coronary collateral circulation, and moderate mitral valve regurgitation. ALCAPA was confirmed using angiotomography. The LCA was surgically reimplanted into the aorta. After 3 years of postoperative follow-up, the patient developed an LCA aneurysm. Diagnosis of cardiac ischemia in childhood remains a challenge, and careful evaluation of coronary arteries on the echocardiogram is an important tool. In this report, we present a case of ALCAPA with an uncommon postoperative outcome.