The burden of stroke in Brazil in 2016: an analysis of the Global Burden of Disease study findings.

OBJECTIVE: To analyze the epidemiological stroke data of Brazil according to the Global Burden of Disease (GBD) study in 2016 and secondary data from the GBD database. RESULTS: The highest percentage of deaths due to stroke in general occurred in individuals aged 70 years or over (60.2%; 95% confidence interval [CI] 59.9-60.5%) followed by that in men (52.9%; 95% CI 52.6-53.2%). Ischemic stroke was the most common type, accounting for 61.8% (95% CI 61.5-62.1%) of deaths due to stroke in 2016. Most of the epidemiological indicators (incidence, prevalence, mortality-to-incidence ratio, mortality, disability-adjusted life years, years lost due to disability, and years of life lost) of stroke in general or either type of stroke were higher in men and those aged 70 years or over. Stroke data in Brazil are a major concern and represent a real health challenge for the coming decades. Men and individuals aged 70 years or older appear to represent the groups with the highest epidemiological parameters and risk for the various stroke outcomes. However, this does not mean the female data are irrelevant, which, although representing a lower risk than the male data, also raise the need for policies aimed at prevention and improvement in the treatment of stroke and its sequelae.

Correlation between municipal human development index and stroke mortality: a study of Brazilian capitals.

OBJECTIVE: To analyze the correlation between municipal human development indices (MHDIs) and stroke mortality in residents of Brazilian state capitals in 2010. A secondary data analysis was conducted in 2015 using data for the MHDI and the following dimensions: income, longevity and education which were obtained from the United Nations Development Program. Additionally, we analyzed age-standardized stroke mortality data from the Department of System Information Unified Health of Brazil. RESULTS: We observed a correlation between stroke mortality and MHDIs overall (Pearson r = - 0.563; p = 0.002) and within the following dimensions: income (Spearman's ρ = - 0.479; p = 0.011), longevity (Pearson r = - 0.510; p = 0.006) and education (Pearson r = - 0.592; p = 0.001). We identified moderate but significant negative correlations between MHDI overall and in its individual dimensions (income, longevity, and age) and stroke mortality in Brazilian capitals. Stroke is the second leading cause of death in industrialized countries and the leading cause of death in Brazil. Therefore, the discovery of factors that may influence the epidemiology of stroke is important for the construction of adequate policies considering to the socioeconomic status in these places and with an emphasis in lower socioeconomic status places.

Evaluation of functional rehabilitation physiotherapy protocol in the postoperative patients with anterior cruciate ligament reconstruction through clinical prognosis: an observational prospective study.

BACKGROUND: The aim of the study was to evaluate the evolution of patients subject to physical treatment based on guidelines of functional rehabilitation after surgery anterior cruciate ligament reconstruction. METHODS: This is a prospective study of 177 patients with anterior cruciate ligament injury, who underwent surgery and physical therapy guideline conducted in an orthopedic clinic in São Paulo, southeastern Brazil. The clinical evolution of patients was made according to Lysholm and IKDC questionnaire on the 1st day after surgery with 30, 90 and 180 days of treatment. RESULTS: There was statistically significant increase in the gross values of Lysholm and IKDC questionnaires during the treatment (p < 0.001), which indicates progressive gain of function. According to the scores obtained from the IKDC, it can be observed that in stage 1 the average progress was 53.5 %, falling to 50 % in stage 2, and 26.1 % in stage 3. As to Lysholm score, it started with 87.7 %, falling to 62.6 % in the second stage and 7 % in the third stage, both statistically significant (p < 0.001). The rehabilitation-oriented functional objectives priority is to quickly get the exercises to gain breadth, strength and proprioception, optimizing and improving the integration of the athlete back to sport. CONCLUSION: Synthesizing the gradual gain of function and according to clinical outcomes assessed by IKDC and Lysholm, the functional guideline presented may be considered an alternative for rehabilitation of patients in postoperative anterior cruciate ligament.