Nagib Haddad

Epidemiological Survey of Skin Diseases in Schoolchildren Living in the Purus Valley (Acre State, Amazonia, Brazil)

A total of 9,955 schoolchildren aged 6-16 years have been examined in a tropical region. The prevalence of dermatosis varied from 21 to 87% in the municipalities surveyed. The most common dermatoses were pediculosis (prevalence 50%), nevi (16.8%), pityriasis versicolor (13.2%), pyoderma (12.2%), pityriasis alba (9.9%), dermatophytosis (6.2%), viral dermatosis (6.2%), scabies (3.0%) and acne vulgaris (2.7%). The prevalence of angular stomatitis, miliaria rubra, candidiasis, piedra nigra, keratosis pilaris, ephelides and geographic tongue is lower but still relatively high. Females had higher rates of pediculosis capitis and males higher prevalence of pityriasis alba. The prevalence of pityriasis versicolor, pigmented nevus and scabies was similar in males and females. Folliculitis, macular pigmented nevi and especially pityriasis versicolor tended to increase with age. Leprosy is hyperendemic in the surveyed area and its rate in the schoolchildren examined was 0.08%. Population movement (urbanization), socioeconomic situation, living conditions, promiscuity, and lack of hygiene may be the cause of such high prevalence and of association of two or more skin conditions. Climatic conditions might have enhanced the prevalence of certain dermatoses (pityriasis versicolor, dermatophytosis, piedra nigra, candidiasis, miliaria rubra).

Cirurgia de revascularização miocárdica: resultados do Sistema Único de Saúde

FUNDAMENTO: A cirurgia de revascularizacao do miocardio (CRM) e a cirurgia cardiaca mais frequentemente praticada no pais, sendo a maior parte realizada pelo Sistema Unico de Saude (SUS). OBJETIVO: Avaliar os resultados da CRM, nao associada a outros procedimentos. METODOS: Analisaram-se as informacoes do banco de dados SIH/DATASUS, disponibilizado on-line. Esse banco de dados contem informacoes relativas a: sexo, idade, permanencia hospitalar, valor da autorizacao de internacao hospitalar (AIH), numero de cirurgias realizadas por hospital e mortalidade hospitalar. Avaliaram-se apenas as CRM realizadas sem procedimentos associados. RESULTADOS: Entre 2005 e 2007 foram realizadas 63.529 cirurgias em 191 hospitais. Foram excluidos 16 hospitais de muito baixo volume cirurgico, restando 63.272 cirurgias para analise final. A mortalidade hospitalar total foi de 6,22%, sendo maior nos hospitais de pequeno volume do que nos de grande volume (> 300 cirurgias no periodo), 7,29% versus 5,77% (p 65 anos), 4,21% versus 9,36% (p<0,001). Encontrou-se uma pequena variacao no valor da AIH entre a regiao Sul, R

Long-term clinical outcomes of the Drug-Eluting Stents in the Real World (DESIRE) Registry.

7.214,63 e Nordeste, R

Myocardial revascularization surgery (MRS): results from National Health System (SUS)

6.572,03 (p<0,01). A distribuicao regional de cirurgias foi desigual, Sul e Sudeste concentram 77% delas. CONCLUSAO: A CRM realizada pelo SUS tem mortalidade maior nos hospitais de baixo volume, nas mulheres e nos idosos. Futuros estudos prospectivos se fazem necessarios.BACKGROUND Myocardial revascularization surgery (MRS) is the most common surgery in this country, with most being performed through the National Health System(SUS). OBJECTIVES To assess MRS results when not associated to other procedures. METHODS The information from the Hospital Information System (SIH/DATASUS) made available online was submitted to analysis. The data include information on gender, age, hospital stay period, hospital admission authorization (AIH) costs, number of surgeries at each hospital, and in-hospital mortality rate. Only MRS with no associated procedures were analyzed. RESULTS A total of 63,529 surgeries were performed in the period between 2005 and 2007 at 191 hospitals. Sixteen hospitals reporting very low surgery volume were excluded. The remaining total number of surgeries came down to 63,272 for the final analysis. In-hospital mortality rate was 6.22%, with small surgery volume hospitals reporting higher rate than high volume hospitals (>or=300 surgeries in the time period under study), 7.29% versus 5.77% (p<0.001). Average hospital stay time length was 12 days, with no difference having been reported between low (12.08+/-5.52) and high volume (12.15+/-7.70) hospitals. Males reported lower mortality rate than females - 5.20% versus 8.25% (p<0.001), similarly to younger individuals when compared to the elderly (>or= 65 years of age), 4.21% versus 9.36% (p<0.001). A slight variation was observed in AIH values between the Southern Region (R

Intervenção coronariana percutânea no Brasil: resultados do Sistema Único de Saúde

7.214,63 - approximately US

Consequences of the Prolonged Waiting Time for Patients Candidates for Heart Surgery

3,600.00) and the Northeastern Region (R

Custos hospitalares da cirurgia de revascularização do miocárdio em pacientes coronarianos eletivos

6.572,03 - approximately US

Produtividade em hospitais de ensino no estado de São Paulo, Brasil

3,280.00) (p<0.01). Regional distribution of surgeries was not comparable in all regions in the country, with Southern and Southeastern Regions having reported 77% of them. CONCLUSION MRS performed by SUS has reported high mortality rate in low volume hospitals, among women, and among the elderly. Future prospective studies are deemed to be necessary.

Percutaneous coronary intervention in Brazil: results from the Brazilian Public Health System

BACKGROUND Recently, cardiologists have treated more complex patients and lesions with drug-eluting stents (DES). However, long-term efficacy and safety of the off-label use of these new devices is yet to be demonstrated. METHODS The Drug-Eluting Stents in the Real World (DESIRE) registry is a prospective, nonrandomized single-center registry with consecutive patients treated solely with DES between May 2002 and May 2007. The primary end-point was long-term occurrence of major adverse cardiac events (MACE). Patients were clinically evaluated at 1, 3, and 6 months and then annually up to 5 years. RESULTS A total of 2,084 patients (2,864 lesions and 3,120 DES) were included. The mean age was 63.8 +/- 11.5 years. Diabetes was detected in 28.9% and 40.7% presented with acute coronary syndrome. Cyphertrade mark was the predominant DES in this registry (83.5%). Mean follow-up time was 2.6 +/- 1.2 years and was obtained in 96.5% of the eligible patients. Target lesion revascularization (TLR) was performed in 3.3% of the patients. Q wave myocardial infarction (MI) occurred in only 0.7% of these patients and total stent thrombosis rate was 1.6% (n = 33). Independent predictors of thrombosis were PCI in the setting of MI (HR 11.2; 95% CI, 9.6-12.4, P = 0.001), lesion length (HR 4.6; 95% CI, 3.2-5.3, P = 0.031), moderate to severe calcification at lesion site (HR 13.1; 95% CI, 12.1-16.7, P < 0.001), and in-stent residual stenosis (HR 14.5; 95% CI, 10.2-17.6, P < 0.001). CONCLUSION The use of DES in unselected population is associated with long-term safety and effectiveness with acceptable low rates of adverse clinical events.

Congenital malformations in hospital admissions in Ribeirão Preto, State of S. Paulo, Brazil

FUNDAMENTO: A cirurgia de revascularizacao do miocardio (CRM) e a cirurgia cardiaca mais frequentemente praticada no pais, sendo a maior parte realizada pelo Sistema Unico de Saude (SUS). OBJETIVO: Avaliar os resultados da CRM, nao associada a outros procedimentos. METODOS: Analisaram-se as informacoes do banco de dados SIH/DATASUS, disponibilizado on-line. Esse banco de dados contem informacoes relativas a: sexo, idade, permanencia hospitalar, valor da autorizacao de internacao hospitalar (AIH), numero de cirurgias realizadas por hospital e mortalidade hospitalar. Avaliaram-se apenas as CRM realizadas sem procedimentos associados. RESULTADOS: Entre 2005 e 2007 foram realizadas 63.529 cirurgias em 191 hospitais. Foram excluidos 16 hospitais de muito baixo volume cirurgico, restando 63.272 cirurgias para analise final. A mortalidade hospitalar total foi de 6,22%, sendo maior nos hospitais de pequeno volume do que nos de grande volume (> 300 cirurgias no periodo), 7,29% versus 5,77% (p 65 anos), 4,21% versus 9,36% (p<0,001). Encontrou-se uma pequena variacao no valor da AIH entre a regiao Sul, R