Background Stroke is the second leading cause of death and disability around the world. Objective The purpose of this study is to evaluate the age- and sex-specific mortality rates related to stroke in the state of Paraná, Brazil, between 2007 and 2016. Methods In this cross-sectional study, residents in the state of Paraná were selected by death certificates (from 2007–2016); the basic cause of death was stroke. A descriptive analysis was performed, and mortality rates were calculated with a 95% confidence interval (95% CI) for each year. Results From 2007 to 2016, there were 62,607 deaths in the state of Paraná due to stroke. Most individuals had medical assistance before death (85.7% in 2007 versus 83.9% in 2016), and most of these deaths occurred in hospitals (73.6% in 2007 versus 74.8% in 2016). Death rates due to stroke increased from 138 (95% CI 135–142) to 163 (95% CI 159–166) per 100,000 inhabitants. This raise occurred mainly in those over 79 years old. For the ages groups of 34 to 44 and 44 to 54 years, mortality rate decreased. Conclusions In the past 15 years, despite the advances in the diagnosis and treatment of stroke, there has been an increase in mortality due to stroke in the state of Paraná. This fact is possibly associated with the aging of the population because there was a more pronounced increase in the group over 79 years old. Thus, new health strategies are necessary to improve the survival and quality of life of poststroke individuals.

Background: Stroke represents the second leading cause of death and disability in Latin America. Thus, there is a constant need to understand the profile of patients admitted for stroke, as well as to analyze the quality indicators of treatment centers. Objectives: The aim of this study was to analyze the quality indicators of a stroke center in a tertiary service and to determine the epidemiological profile of inpatients. Design and setting: Observational cross- sectional study. Stroke unit from a tertiary center. Methods: The individuals included in the study were those admitted with stroke or TIA in the stroke unit of the Hospital de Clínicas - UFPR from November 2020 to April 2021. The variables and quality indicators were collected through the application of questionnaires in two moments, on admission and hospital discharge. Results: Of the 132 patients included, 53.8% were men, with a mean age of 62.7 years (SD +/- 17.5). Ischemic stroke was the most common type of stroke, accounting for 77.3% of cases. The majority of patients (68.9%) did not receive specific intervention, while 31% underwent intravenous thrombolysis, with a median door-to-needle time of 35 minutes. In 80.4% of the individuals, thrombolysis started in less than 60 minutes. All patients underwent neuroimaging, 87.4% underwent carotid imaging and 77.9% were monitored with Holter. Dysphagia screening was applied in 58.3% of cases. Regarding secondary prevention, 48.1% received antiplatelet drugs and 25.2% received anticoagulants. Conclusions: Intravenous thrombolysis is not performed in most hospitalized patients, however, when performed, it presents an adequate door-to-needle time. Hospitalization in a stroke unit allows a complete etiological investigation and optimization of secondary prevention and rehabilitation.

Background: The peripheral polyneuropathies have etiological heterogeneity, with more than a hundred known causes. In addition, they have a lack of information related to their epidemiology. Objectives: The aim of this study is to determine the prevalence of each etiology of polyneuropathy in a single specialized center from Southern Brazil and to correlate main clinical manifestations and electrophysiological aspects. Design and setting: Observational cross-sectional study. Neuromuscular disorder center from a tertiary service. Methods: This study comprised individuals with electrodiagnostic tests compatible with polyneuropathy from a neuromuscular disorder center. Selected patients were those who underwent nerve conduction studies between 2008 and 2017. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: The sample population consisted of 380 patients who has a male predominance (59.5%), with a median age of 43 years (26-57). The main etiologies were inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%) and diabetes (10.8%). The main electrophysiological patterns were Axonal Sensorimotor Polyneuropathy (36.1%) and Demyelinating- Axonal Sensorimotor Polyneuropathy (27.9%). Idiopathic, diabetic, and multifactorial polyneuropathies had predominantly axonal pattern, while inflammatory and hereditary polyneuropathies had mainly demyelinating pattern. Conclusions: The frequency of inflammatory etiology was higher than previously described and frequency of diabetic polyneuropathy was lower. There may be a change in epidemiology of polyneuropathy in specialized centers, with a tendency to decrease idiopathic polyneuropathy. Electrodiagnostic testing is useful for etiological diagnosis since electrophysiological patterns correlate with specific etiologies.

Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging. Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects. Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and “demyelinating and axonal” sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and “demyelinating and axonal” polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies. Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies.

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