Foi realizado um estudo seccional de campo do tipo "caso controle" sobre a morbilidade da doença de Chagas em quatro áreas endêmicas no Brasil, duas no Estado de Minas Gerais, uma no Estado do Piauí e outra no Estado da Paraíba, incluindo 716 pares de indivíduos da mesma idade e sexo, cada par constando de um indivíduo com sorologia positiva e outro com sorologia negativa para a infecção chagásica. Com esse tipo de estudo procurou-se determinar o componente exclusivamente chagásico na morbidade da doença em diferentes áreas do país. O gradiente de manifestações clínicas e alterações eletrocardiográficas entre o grupo com sorologia positiva e outro com sorologia negativa, estudado em 264 pares na área de Iguatama-Paris e 274 em Virgem da Lapa, ambas em Minas Gerais, e em 109 pares estudados nas localidades de Colônia e Oitis, em Oeiras, Piauí e em 69 nos municípios de Aguiar e Boqueirão dos Cochos na Paraíba, mostra nitidas diferenças regionais na morbilidade da doença. Nas áreas de Minas Gerais, embora a transmissão natural da infecção estivesse interrompida há 15 e 5 anos, respectivamente, o grau de morbilidade cardiológica pelo componente chagásico, considerando apenas as alterações eletrocardiográficas mais expressivas e específicas, no momento do estudo, foi de aproximadamente 30%, enquanto em Oeiras, no Piauí e em Aguiar e Boqueirão dos Cochos, na Paraíba, mesmo com transmissão ativa da infecção, a morbidade cardiológica pelo componente chagásico foi inferior a 15 e 10%, respectivamente

Objectives: This study evaluated the safety and hospital impact of transition from a routine to a selective policy of postoperative transfer to the intensive care unit (ICU) for elective open abdominal aortic aneurysm (AAA) repair.Methods: This retrospective study included all open elective AAA repairs from August 8 2010, to December 1, 2014, performed in our center. The study was approved by the Institutional Review Board, and informed consent was waived. Patients were identified through our prospective database, and electronic records were reviewed to extract patient characteristics, operative details, and postoperative complications. Patients operated on before March 13, 2012, were routinely sent to the ICU after operation (group A). Patients treated after this date were sent directly to an intermediate care unit with a ratio of one nurse for three patients (group B), unless otherwise determined preoperatively by the surgeon or after intraoperative complications. We evaluated the safety of our change in practice, looking at complications and mortality rate, length of stay, and transfer from an intermediate care unit to the ICU.Results: The study included 310 patients (266 men, 44 women), with a mean age 70 of years, and a mean AAA diameter 65 mm. Group A and B included 118 and 192 patients, respectively. The postoperative mortality rate was similar in each group (1%). ICU admission in group B was spared in 78% (149 of 192) of patients. Only two patients (1%) from the intermediate care unit were subsequently admitted to the ICU. There was no increase in mortality in group B (0.5%) compared with group A (0.8%) during hospital stay. Hospital lengths of stay were similar between groups group A (8.6 days) and group B (8.0 days; P ¼ NS).Conclusions: Our results confirm the safety of a selective ICU pathway after open elective AAA repair, with most patients sent directly to an intermediate care unit.