A radioimmunoassay for alpha‐feto‐protein (AFP) has been used to compare the distribution of AFP levels in adults and children from areas of southern Africa who have increased susceptibility to primary liver cancer (PLC) and non‐susceptible children of other races from the same areas. The serum AFP values in pregnant women, ill Bantu patients, proven PLC cases who were AFP‐negative on immunodiffusion, and patients with hepatitis have been determined. People from PLC high‐risk areas appear to have raised AFP levels more often than in other populations. There is a complete overlap between normal levels and levels in hepatitis and PLC. The dynamics of the AFP response assists in distinguishing hepatitis from PLC. The AFP in maternal serum shows fluctuations, a fall before delivery, and a spike of AFP on disruption of the placenta.
Objective: To analyze the number of endoscopic thoracic sympathectomies performed to treat hyperhidrosis in the Universal Public Health System of Brazil, the government reimbursements, and the in-hospital mortality rates. Background: Even though endoscopic thoracic sympathectomy has been widely performed for the definitive treatment of hyperhidrosis, no series reported mortality and there are no population-based studies evaluating its costs or its mortality rate. Methods: Data referring to endoscopic thoracic sympathectomy to treat hyperhidrosis between 2008 and 2019 were extracted from the database of the Brazilian Public Health System, which insures more than 160 million inhabitants. Results: Thirteen thousand two hundred one endoscopic thoracic sympathectomies to treat hyperhidrosis were performed from 2008 to 2019, with a rate of 68.44 procedures per 10 million inhabitants per year. There were 6 in-hospital deaths during the whole period, representing a mortality rate of 0.045%. The total expended throughout the years was U$ 6,767,825.14, with an average of U$ 512.68 per patient. Conclusions: We observed a rate of 68.44 thoracoscopic sympathectomies for hyperhidrosis' treatment per 10 million inhabitants per year. The inhospital mortality rate was very low, 0.045%, though not nil. To our knowledge, no published series is larger than ours and we are the first authors to formally report deaths after endoscopic thoracic sympathectomies to treat hyperhidrosis. Moreover, there is no other population-based study addressing costs and mortality rates of every endoscopic thoracic sympathectomy for the treatment of any site of hyperhidrosis in a given period.
Introduction
Although endovascular correction is a promising perspective, the
gold-standard treatment for thoracoabdominal aortic aneurisms and type-B
dissections with visceral involvement remains open surgery, particularly due
to its well-established long-term durability. This study aims to describe
and evaluate public data from patients treated for thoracoabdominal aortic
aneurism in the Brazilian public health system in a 12-year interval.
Methods
Data from procedures performed between 2008 and 2019 were extracted from the
national public database (Departamento de Informática do Sistema
Único de Saúde, or DATASUS) using web scraping techniques.
Procedures were evaluated regarding the yearly frequency of elective or
urgency surgeries, in-hospital mortality, and governmental costs. All tests
were done with a level of significance P<0.05.
Results
A total of 812 procedures were analyzed. Of all surgeries, 67.98% were
elective cases. There were 328 in-hospital deaths (mortality of 40.39%).
In-hospital mortality was lower in elective procedures (26.92%) than in
urgency procedures (46.74%) (P=0.008). Total governmental expenditure was
$3.127.051,56 — an average of $3.774,22 for elective surgery and $3.791,93
for emergency surgery (P=0.999).
Conclusion
The proportion of urgency procedures is higher than that recommended by
international literature. Mortality was higher for urgent admissions,
although governmental costs were equal for elective and urgent procedures;
specialized referral centers should be considered by health policy
makers.
In Brazil, descending thoracic aorta disease, including aneurysms and dissections, is managed preferentially by endovascular treatment, owing to its feasibility and good results. In this study, we analyzed endovascular treatment of isolated descending thoracic aortic disease cases in the Brazilian public health system over a 12-year period. METHODS: Public data from procedures performed from 2008 to 2019 were extracted using web scraping techniques to assess procedure type frequency (elective or urgency), mortality, and governmental costs. RESULTS: A total of 5,595 procedures were analyzed, the vast majority of which were urgent procedures (61.82% vs. 38.18%). In-hospital mortality was lower for elective than for urgent surgeries (4.96 vs. 10.32%, p=0.008). An average of R$16,845.86 and R$20,012.04 was paid per elective and emergency procedure, respectively, with no statistical difference (p=0.095). CONCLUSION: Elective procedures were associated with lower mortality than urgent procedures. There was no statistically significant difference between elective and urgent procedures regarding costs.
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