Low birth weight is related to morbidity and mortality and sequelae during infant development, thereby impacting health system costs. It is thus important to evaluate factors that influence low birth weight and to estimate their impact on the Brazilian Unified National Health System (SUS). This was a nested prospective study in a cohort of pregnant women who received prenatal care and gave birth in the National Health System in hospitals with ICUs in the city of Pelotas, Rio Grande do Sul State, Brazil. Gestational depression was associated with a fourfold risk of low birth weight (PR = 3.94; CI: 1.49-10.36). Based on the population-attributable fraction, in the overall population an estimated 36.17% of low birth weight infants are born to mothers with an episode of depression during pregnancy, with an estimated cost of more than R$76 million (U$38 million) in Brazil. The study recommends the expansion of preventive and therapeutic mental health care measures for pregnant women and the adequate use of resources in the Unified National Health System to improve neonatal outcomes.
Objective: To evaluate the prevalence and factors associated with non-vaccination against influenza in the risk group. Methods: A cross-sectional, population-based study, carried out in the city of Rio Grande (RS). The outcome was defined as belonging to risk groups and not having been vaccinated in the last 12 months. Demographic, socioeconomic, behavioral variables, and access for health services were analyzed. Results: In this study, 680 individuals participated. The prevalence was 46.0% (95%CI: 41.8-50.3), ranging from 27.9% (elderly) to 81.8% (pregnant women). Young adults, single, intermediate socioeconomic bracket, smoker, with depressive symptoms, who did not perform physical activity and did not consult a physician in the last year, had a higher prevalence of non-vaccination. Conclusion: Half of the sample was not vaccinated in the period. Due to the similarity of influenza-like illness and the coronavirus 2019 disease (COVID-19), increasing vaccination would minimize mortality and use of hospital beds due to influenza, optimizing the response of hospital capacity.
A Bronquiolite, que ocorre frequentemente em lactentes jovens, com predomínio nos meses de inverno. É sensível a atenção primária à Saúde (APS) pela portaria nº 221 do dia 17 de abril de 2008 do Ministério da Saúde, porém ocupa um grande contingente hospitalar. Se observou os índices de internação hospitalar referentes à bronquiolite em crianças de faixa etária de 0-9 anos, no período de 2012/2013, em Pelotas, avaliando a qualidade da atenção básica e seus efeitos no processo de internação. Constatou-se que ocorreram 323 internações, sendo 174 em 2012 e 149 em 2013. A faixa etária mais prevalente foi em crianças menores de 1 ano (83,59%), após 1-4 anos (15,17%), e 5-9 anos (1,23%). A doença é autolimitada e é prevenível por medidas simples de higiene, é possível depreender que o número de hospitalizações por bronquiolite pode estar relacionada à carência de ações de prevenção efetivas nos serviços de APS.
The COVID-19 pandemic has impacted public and private health systems around the world, impairing good practices in women’s health care. However, little is known about the experiences, knowledge, and feelings of Brazilian women in this period. The objective was to analyze the experiences of women, seen at maternity hospitals accredited by the Brazilian Unified Health System (SUS, acronym in Portuguese), regarding health care during pregnancy, childbirth, and postpartum periods, their interpersonal relationships, and perceptions and feelings about the pandemic. This was a qualitative, exploratory research, carried out in three Brazilian municipalities with women hospitalized in 2020, during pregnancy, childbirth, or postpartum period, with COVID-19 or not. For data collection, semi-structured individual interviews (in person, by telephone, or by digital platform) were conducted, recorded and transcribed. The content analysis of thematic modalities was displayed as per the following axes: i) Knowledge about the disease; ii) Search for health care in prenatal, childbirth, and postpartum periods; iii) Experience of suffering from COVID-19; iv) Income and work; and v) Family dynamics and social support network. A total of 46 women were interviewed in São Luís-MA, Pelotas-RS, and Niterói-RJ. Use of media was important to convey information and fight fake news. The pandemic negatively impacted access to health care in the prenatal, childbirth, and postpartum periods, contributing to worsening of the population’s social and economic vulnerabilities. Women experienced diverse manifestations of the disease, and psychic disorders were very frequent. Social isolation during the pandemic disrupted the support network of these women, who found social support strategies in communication technologies. Women-centered care–including qualified listening and mental health support–can reduce the severity of COVID-19 cases in pregnant, parturient, and postpartum women. Sustainable employment and income maintenance policies are essential to mitigate social vulnerabilities and reduce risks for these women.
Por mais de um século, a apendicectomia convencional (aberta) foi o único tratamento padrão para apendicite. Entretanto, a abordagem videolaparoscópica (VLP), técnica contemporânea e mais sofisticada, revolucionou o manejo desta patologia. Objetivo: este estudo tem por objetivo realizar uma análise descritiva e transversal sobre as internações hospitalares por apendicectomia convencional e videolaparoscópica realizadas pelo SUS no Brasil. Métodos: trata-se de um estudo descritivo e transversal, realizado por meio da análise de dados secundários, oriundo do Sistema de Informações Hospitalares (SIH), sobre as apendicectomias (convencional e videolaparoscópica) ocorridas no Sistema Único de Saúde (SUS), no Brasil, no período de 2009 a 2018. Resultados: a cirurgia videolaparoscópia apresentou menor número de óbitos por procedimentos, menor taxa de mortalidade e maior custo por internação, em relação a cirurgia convencional. O tempo médio de dias de permanência hospitalar não teve diferença estatisticamente significamente entre as técnicas. Além disso, para ambas as técnicas (seja aberta ou VLP), os dados sugerem um crescente aumento no número total e valor médio de internação. Quanto à evolução temporal, para ambas as técnicas, os números sugerem uma taxa decrescente para o tempo médio de internação e a taxa de mortalidade. Considerações finais: a apendicectomia por vídeo no SUS apresentou mais vantagens assistenciais e financeiras, sugerindo-se que criem-se políticas de financiamento e estímulo para ampliação da realização deste método, frente ao método aberto.
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