Mortality Profile Research Articles

Effect of essential oils against acaricide\u2010susceptible and acaricide-resistant Rhipicephalus ticks

The indiscriminate use of acaricides is a problem worldwide and has increased the selection of acaricide-resistant tick populations. The goal of this study was to evaluate the acaricide effects of two essential oils (from Schinus molle and Bulnesia sarmientoi) using the larval immersion test on three Rhipicephalus tick species. Rhipicephalus evertsi, Rhipicephalus appendiculatus and Rhipicephalus pulchelus ticks collected in Kenya, without history of acaricide exposure, were tested, as well as individuals from two populations of Rhipicephalus microplus (with or without history of acaricide exposure), for comparison. The sample most resistant to the treatments was a population of R. microplus with previous acaricide exposure, whereas the least tolerant sample was a strain of the same species that never had contact with acaricides (Porto Alegre strain). Interestingly, the field tick samples without previous acaricide exposure responded to essential oils with a mortality profile resembling that observed in the acaricide-resistant R. microplus field population, and not the susceptible Porto Alegre strain. The essential oil of B. sarmientoi and its two components tested (guaiol and bulnesol) caused the highest mortality rates in the tested species and are potential molecules for future studies on control methods against these species.

Clinical Characteristics and Mortality Profile of COVID-19 Patients Aged less than 20 years Old in Pernambuco - Brazil.

ABSTRACTCOVID-19 in children and adolescents has low frequency, severity, and fatality rate all over the world. A cross-sectional study was conducted to assess the epidemiological and clinical aspects of COVID-19 in patients younger than 20 years in Pernambuco (Brazil), with cases confirmed by reverse-transcriptase–PCR SARS-CoV-2 between 13 February and June 19, 2020, reported on information systems. Data regarding age (< 30 days, 1–11 months, 1–4 years, 5–9 years, 10–14 years, and 15–19 years), gender, color/race, symptoms, pregnancy or puerperium, comorbidities, hospitalization, and death were investigated. Fatality rate and mortality coefficient were calculated, and a multiple logistic regression analysis was performed to determine if gender, age, and comorbidities were factors associated with death. Of 682 pediatric cases, 52.8% were female, with a mean age of 9 ± 7.2 years. The most frequent symptoms were fever (64.4%), cough (52.4%), and respiratory distress (32.4%). Hospitalization was reported in 46.2% of cases, mainly among neonates (80.3%) and infants (73.8%). Thirty-eight deaths were notified, and a fatality rate of 5.6% (95% CI: 3.9–7.3) was found, with higher fatality rates among neonates 11.5% (7 of 61) and 9.5% (8 of 84) infants. The mortality coefficient was 10.9 per 100,000 inhabitants < 1 year of age, whereas comorbidities (Odds ratio [OR] = 14.13, 95% CI: 6.35–31.44), age < 30 days (OR = 5.17, 95% CI: 1.81–14.77), and age 1–11 months (OR = 3.28, 95% CI: 1.21–8.91) were independent factors associated with death. The results demonstrate the vulnerability of neonates and infants with severe conditions, need hospitalization, and high fatality rate, indicating the necessity to adapt public health policies for these age-groups.

Clinicobiochemical Parameters and Predictors of Liver Disease in Hospitalized Asian Indian Pregnant Women in a Tertiary Care Center in Northern India

Introduction During pregnancy, liver dysfunction is more frequent than expected and may require specialized care. For the early diagnosis, it is important to determine if changes in liver physiology may develop into liver disease. Liver disease during pregnancy may require intervention from a hepatologist for adequate monitoring of mother-fetus health outcomes. This study was aimed to evaluate the clinical profile and predictors of maternal mortality in patients with liver diseases among Asian-Indian-females.MethodsWe conducted a prospective, open-label, consecutive all-comers study of 2,663 pregnant Asian Indian women admitted in the hospital, which included 92 with liver dysfunction. The medical aspects of the pregnancy were then followed prospectively with laboratory and clinical data during the hospital stay and analyzed. The current study was approved by the Institutional Ethical Committee.ResultsWe found that 92 out of 2,663 patients had liver dysfunction with a prevalence of 3.45%. Fifty-four (58.7%) patients had icterus followed by fever in 23 (25.0%), hypertension in 22 (23.9%), central nervous system manifestations in 21 (22.8%), abdominal pain in 19 (20.6%), vomiting in 19 (20.6%), and pruritus in six (6.5%). Predictors of maternal mortality were icterus (p = 0.04), hepatomegaly (p = 0.04), presenting serum-bilirubin greater than 10 milligram% (mg%) (p = 0.008). The most common etiology was acute viral hepatitis (45.6%), followed by a hypertensive disorder of pregnancy (29.3%), acute fatty liver of pregnancy (1.1%), cholestatic jaundice (9.8%), hyperemesis gravidarum (2.2%), septicemic hepatitis (3.3%), dengue immunoglobulin M (IgM), and plasmodium vivax malaria antigen positive in (2.2%) each. Four patients (4.3%) were leptospira IgM reactive and had co-infection with hepatitis E virus. There was one patient (1.1%) with underlying chronic liver disease. Idiopathic liver disease was present in 5.4% of patients.ConclusionLiver disease is relatively common in Indian pregnant women. It is associated with high maternal and perinatal mortality, even in a tertiary referral center. When managing pregnancy in a tertiary care center, for adequate follow-up of the disease and to prevent adverse consequences for mother and child, it is important to discard liver alterations early. For this purpose, liver disease during pregnancy needs early diagnosis for proper management. Furthermore, it is difficult to manage patients with preexisting liver disease, and it may require specialized intervention from a hepatologist and a gastroenterologist.

Comparative Study of Demographic Profile, Mortality, Risk Factors, and Bacteriological Profile of Respiratory Isolates from Ventilated Patients: Ventilator-Associated Event versus NonVentilator-Associated Event Cases

Introduction: Ventilator-associated pneumonia (VAP) rate has long been considered a quality indicator (QI) in intensive care units (ICUs) for mechanically ventilated patients. However, ever since the Centers for Disease Control and Prevention (CDC) redefined VAP as ventilator-associated events (VAEs), its validity as a tool for use in quality assurance needs to be assessed. Aim: The aim of the study was to identify VAE rate in ICU, compare the demographic and respiratory isolate profile and mortality with non-VAE cases, and identify risk factors for VAE. Materials and Methods: All ICU patients on mechanical ventilation (MV) for >2 days were followed prospectively. VAE data were collected using a checklist obtained from the CDC website (the National Healthcare Surveillance Network VAE surveillance tool). The demographic profile, risk factors, and treatment for each patient were recorded in a proforma. VAE rates were estimated per 1000 ventilator-days. Results: The overall VAE rate was 38.1/1000 MV days. Among VAE subtypes, 18.7% were ventilator-associated condition (VAC), 43.7% were infection-related VAC (IVAC), and 37.5% were possible VAP (PVAP). Survival rate was 100% for patients with VAC alone, whereas only 14.2% and 16.6% of patients survived with IVAC and PVAP, respectively. No significant association was found between age, gender, mortality, bacterial isolate, and VAE cases. Depressed level of consciousness, immunosuppression, antibiotic use, and reintubation were significant risk factors associated with VAE cases (P = 0.0001). Conclusion: There is no significant difference observed between VAE and non-VAE cases regarding demographic profile, respiratory bacterial profile, and mortality. More research is required to establish the role of VAE as a QI for patient care in ICUs.

Mortality among pediatric hematopoietic stem cell transplantation patients: Report from a single center in southern Brazil.

HSCT has grown in number in recent years. This treatment in children has its particularities and has been characterized in previous studies only on a limited basis. There are important causes of morbidity and mortality in this group of patients, including evolution of primary disease, graft failure, infectious diseases, and GVHD. The aim of this study was to report case series of TRM within 100days after transplantation and associated factors. Retrospective cohort. All children transplanted between January 1, 2010 and December 31, 2017 were included and those who underwent the first HSCT in another center were excluded. Data from 292 children were analyzed. TRM in 100days was 5.8%, being significantly higher in patients with umbilical cord blood as the cell source. Infectious complications were frequent in this sample (bacterial infections in 27%, viral infections in 75.3%, and fungal infections in 12%) and both the presence of fungal disease and more than one infection during the follow-up (viral and bacterial, viral and fungal or bacterial and fungal) had statistically significant association with the outcome. The prognosis in allogeneic HSCT is influenced by the origin of the stem cells, the presence of acute GVHD and the occurrence of infectious diseases. Studies that evaluate pediatric individuals undergoing HSCT and analyze their mortality profile, can improve the management of these patients, possibly leading to a reduction in TRM.

Epidemiological profile of female firearm-related mortality.

The mortality rate of women due to firearms increases every day in Brazil and globally. This study aimed to evaluate the trends of firearm-related mortality in women from the years 2007 to 2016 in order to determine their profile and to associate these indicators with public policy and strategies to reduce mortality.This is an ecological time-series study using secondary data of women aged 10 to 49 years old collected through the mortality information system (SIM) in Brazil. Furthermore, independent characteristics such as education, color, race and civil status were also collected from SIM. Data was analyzed using the Join Point open source software version.There was an increase in the mortality rate of women who received 4 to the 7 years of education, were single, and brown-skinned. There was a significantly increased rate of mortality in women whose ages ranged from 20 to 29 years followed by 30 to 39 years; the rate was also significantly higher in the northeast region followed by the southeast region.There is a need for professional training to assist women in vulnerable situations.

Severe Acute Respiratory Syndrome by COVID-19 in pregnant and postpartum women

Abstract Objectives: to evaluate the morbidity and mortality profile and factors associated with death due to severe acute respiratory syndrome (SARS) by COVID-19 in pregnant and postpartum women. Methods: this is a quantitative and retrospective research that analyzed the SIVEP-gripe Database (Influenza Epidemiological Surveillance Information System), from 01/01/2020 to 04/01/2021. All pregnant women and postpartum women diagnosed with SARS caused by COVID-19 in the State of Minas Gerais were included. After the descriptive analysis of the hospitalizations profile, the association between different exposure variables and the occurrence of death was evaluated. Results: of the 227 records obtained, 94.3% required hospitalization. Among hospitalizations in the Intensive Care Unit, 29.8% used invasive ventilatory support. Fifteen deaths were recorded. The most frequent clinical manifestations were: cough and fever; the predominant comorbidities were cardiovascular disease and diabetes mellitus. The variables “ICU stay”, “use of ventilatory support” and “heart disease” were associated with the occurrence of deaths. Conclusions: hospitalization was necessary for most pregnant women with SARS and the presence of previous heart disease increased the risk of death. Knowing the SARS morbidity and mortality profile is important in the definition of public health strategies aimed at reducing the impacts of COVID-19 during pregnancy and the puerperium.

Analysis of the epidemiological profile of patients with traumas: A literature review

Trauma is a public health problem, with a high morbidity and mortality profile that generates high costs for health systems all over the world. Several factors can trigger the different types of trauma, which may require specific treatments, often even surgical procedures, and may also cause incapacity for work. In light of this, this research was intended to evaluate the epidemiological profile of patients with traumas in different regions of the world. To this end, a systematic literature review was performed by searching the Scielo database, using the descriptors “trauma” and “epidemiology”, finding a total of 270 articles. Subsequently, filters were applied, which allowed 92 scientific articles to be obtained. The titles and abstracts of these articles were analyzed; and, from that, 15 articles were selected, which were read in full and then discussed. The literature analysis allowed us to characterize the epidemiological profile of traumas in Brazil and in other countries around the world, detecting that most trauma affects men at a young age, which can affect the labor system; that the low level of education can influence the trauma profile; and that factors such as car and motorcycle accidents, falls and physical aggressions are the main etiological factors of cranioencephalic, maxillofacial, thoracic, upper limbs and lower limbs traumas, among others. Thus, there is a need to formulate better preventive measures and pre- and in-hospital treatments, aiming at reducing the impact on trauma morbidity and mortality.

Morbidity and Mortality Profile among Low Birth Weight Neonates- A Cross-sectional Study from Jalandhar, India

Introduction: World Health Organisation (WHO) has defined Low Birth Weight (LBW) as weight at birth of fewer than 2,500 grams in the first hour of delivery. This practical cut-off for international comparison is based on epidemiological observations that infants weighing less than 2,500 gm are approximately 20 times more likely to die than babies with a normal birth weight. LBW is closely associated with neonatal and infant mortality and morbidity and stifled growth and cognitive development of children. Aim: To know the aetiological profile and outcome of admitted Low birth weight babies in Neonatal Intensive Care Unit (NICU). Materials and Methods: The present study was hospital based retrospective study conducted on 610 neonates admitted in NICU at a teaching hospital, Punjab Institute of Medical Sciences, Jalandhar, from January 2019 to December 2019. Neonate with birth weight less than 2500 gm and less than 28 days old were included in the study. The total subjects were divided into three groups- Group 1: Extremely Low Birth Weight (ELBW) &lt;1000 gm; Group 2: Very Low Birth Weight (VLBW): 1000- &lt;1500 gm; Group 3: Low Birth Weight (LBW): 1500-&lt;2500 gm. All the babies were investigated and managed as per standard hospital protocol. Data recorded were: demographic profile, aetiology, morbidity and mortality among LBW babies. Data was analysed using Statistical Package for Social Sciences(SPSS) version 21.0 using standard statistical tests. Results: Total number of LBW babies registered in the study was 610. Among them, weight of 72 (11.8%) of neonates were &lt;1000 g (Group 1), 208 (34.1%) were weighed 1000-&lt;1500 g (Group 2) and 330 (54.1%) were weighed between 1500-&lt;2500 g (Group 3). The mortality rate was 3.77%. The major causes of admission observed in neonates were sepsis (45.2%), hyperbilirubinemia (29.5%), apnoea (24.2%), hypoglycaemia (21.9%) and respiratory distress (17.2%). Highest mortality was observed amongst cases with Extremely Low Birth Weight (ELBW) (p&lt;0.01). Two neonates out of total subjects 19 (3.1%) diagnosed with necrotising enterocolitis (NEC) succumbed to death, both belonging to group 1. Conclusion: The leading cause of morbidity and mortality in LBW babies were sepsis and Necrotising Enterocolitis (NEC) so we need to address this problem more effectively.

The Emergence of Novel SARS-CoV-2 Variant P.1 in Amazonas (Brazil) Was Temporally Associated with a Change in the Age and Gender Profile of COVID-19 Mortality

Background: Since the end of 2020, there has been a great deal of international concern about the variants of SARS-COV-2 B.1.1.7, identified in the United Kingdom; B.1.351 discovered in South Africa and P.1, originating from the Brazilian state of Amazonas. The three variants were associated with an increase in transmissibility and worsening of the epidemiological situation in the places where they expanded. The lineage B.1.1.7 was associated with the increase in case fatality rate in the United Kingdom. There are still no studies on the case fatality rate of the other two variants. The aim of this study was to analyze the mortality profile before and after the emergence of the P.1 strain in the Amazonas state.Methods: We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), comparing two distinct epidemiological periods: during the peak of the first wave, between April and May 2020, and in January 2021 (the second wave), the month in which the new variant came to predominate. We calculated mortality rates, overall case fatality rate and case fatality rate among hospitalized patients; all rates were calculated by age and gender and 95% confidence intervals (95% CI) were determined.Findings: We observed that in the second wave there were a higher incidence and an increase in the proportion of cases of COVID-19 in the younger age groups. There was also an increase in the proportion of women among Severe Acute Respiratory Infection (SARI) cases from 40% (2,709) in the first wave to 47% (2,898) in the second wave and in the proportion of deaths due to COVID-19 between the two periods varying from 34% (1,051) to 47% (1,724), respectively. In addition, the proportion of deaths among people between 20 and 59 years old has increased in both sexes. The case fatality rate among those hospitalized in the population between 20 and 39 years old during the second wave was 2.7 times the rate observed in the first wave (female rate ratio = 2.71; 95% CI: 1.9-3.9], p Interpretation: Based on this prompt analysis of the epidemiological scenario in the Amazonas state, the observed changes in the pattern of mortality due to COVID-19 between age groups and gender simultaneously with the emergence of the P.1 strain suggest changes in the pathogenicity and virulence profile of this new variant. Further studies are needed to better understanding of SARS-CoV-2 variants profile and their impact for the health population.Funding: There was no funding for this study.Declaration of Interest: None to declare.

Socioeconomic and demographic profile of occupational morbidity and mortality in Brazil from 2009 to 2016.

Introduction:Occupational accidents occur as a result of work, and can lead to bodily harm or functional impairments that lead to death, or to the reduction or loss of working capacity. Occupational accidents are associated with two possible outcomes: morbidity or mortality. Morbidity refers to the subset of a population that develops an illness over a given period of time, while mortality refers to the number of individuals who die over a specified time period.Objectives:To assess occupational morbidity and mortality in Brazil in the period of 2009 to 2016.Methods:An ecological study was conducted based on secondary data collected from incident records in the Social Security database.Results:The outcomes of all occupational accidents reported in Brazil from 2009 to 2016 were extracted from the database. These data were then classified by geographical region and category in the National Classification of Economic Activities (Classificação Nacional de Atividades Econômicas), so as to calculate the prevalence of each outcome and the accident mortality rates, and compare these values across regions and occupational categories.Conclusions:The data show that the outcomes of occupational accidents are directly associated with socioeconomic sectors and the sociocultural characteristics of different regions in the country. These results make an important contribution to the characterization of occupational morbidity and mortality in Brazil.

PRO: The pulmonary artery catheter has a paramount role in current clinical practice.

Ever since its clinical introduction, the utilization of the pulmonary artery catheter (PAC) has been surrounded by multiple controversies, mostly related to imprecise clinical indications and the complications derived from its placement. Currently, one of the most important criticisms of the PAC is the ambiguity in the interpretation of its hemodynamic measurements and therefore, in the translation of this data into specific therapeutic interventions. The popularity of the PAC stems from the fact that it provides hemodynamic data that cannot be obtained from clinical examination. The assumption is that this information would allow better understanding of the individual's hemodynamic profile which would trigger therapeutic interventions that improve patient outcomes. Nevertheless, even with the current diversity of hemodynamic devices available, the PAC remains a valuable tool in a wide variety of clinical settings. The authors present a review exposing the benefits of the PAC, current clinical recommendations for its use, mortality and survival profile, its role in goal-directed therapy, and other applications of the PAC beyond cardiac surgery and the intensive care unit.

Mortality Profile of Critical Patients in Medical Intensive Care Unit of Government Medical College of Central India

Introduction: Mortality rate is always very high in Intensive Care Units (ICU) even with the best possible set ups, we should try to cater the need of the society according to the disease burden so that better care can be provided. Aim: To estimate the prevalence of various medical disease mortality profile of critically ill patients admitted in Medical Intensive Care Unit (MICU) of our institution. Materials and Methods: This was a retrospective observational study done at MICU of Bundelkhand Medical College and Hospital Sagar, Madhya Pradesh, India for a duration of one year (1st January 2019 to 31st December 2019). Data was retrieved from Medical Records Department (MRD) and total data of 349 deaths were registered. Disease was classified based upon ICD 10 (International Statistical classification of Diseases and related health problems) Score. Results: A total of 349 deaths occurred in MICU during the period of one year at the institution, out of which male deaths were 55.9% and Female deaths were 44.1%. MICU deaths occurred in higher numbers in males with Male: Female ratio of 1.2:1. This difference in ratio of male and female mortality was not statistically significant (p-value &gt;0.05). Mean age of males at time of death was 58.4±16.3 years whereas mean age of females were 55.2±19.7 years. This difference in mortality with age and gender was not statistically significant (p-value &gt;0.05). In present study, most common systemic causes of mortality were cardiovascular (29.8%), followed by respiratory (17.5%), renal (16.5%) and cerebrovascular diseases (13.8%). Mortality was documented in 276 (79%) individuals within duration of seven days of admission, whereas mortality in 46 (13.1%) and 27 (7.7%) cases were documented within 8 to 14 days and &gt;14 days, respectively. The present study documented no statistically significant association between length of stay and age of patients (p-value &gt;0.05). Conclusion: Cardiovascular diseases are the most common causes leading to mortality especially in elderly male patients. Also, higher number of deaths is reported within seven days of admission signifying severity of illness at the time of admission.

In-hospital mortality in patients with acute limb ischemia over a 12-year period in the Brazilian public health-care system.

BackgroundArterial diseases represent a severe public health problem in the 21st century. Although men have a higher overall prevalence, reports have suggested that women may exhibit atypical manifestations, be asymptomatic, and have hormonal peculiarities, resulting in worse outcomes and severe emergencies, such as acute limb ischemia (ALI).ObjectivesTo analyze the morbidity and mortality profile of ALI emergencies in Brazil between 2008 and 2019.MethodsAn ecological study was carried out with secondary data from SIH/SUS, using ICD-10 code I.74 The proportions of emergency hospital admissions and in-hospital mortality rates (HMR) by gender, ethnicity, and age were extracted from the overall figures. P<0.05 was considered significant.ResultsFrom 2008 to 2019, there were 195,567 urgent hospitalizations due to ALI in Brazil, 111,145 (56.8%) of which were of men. Women had a higher HMR (112:1,000 hospitalizations) than men (85:1,000 hospitalizations) (p<0.05), and a higher chance of death (OR=1.36; p<0.05). Furthermore, mean survival was significantly higher among men (8,483/year versus 6,254/year; p<0.05). Stratified by ethnicity, women who self-identified as white (OR=1.44; p<0.05), black (OR=1.33; p<0.05), and brown (RR=1.25; p <0.05) had greater chances of death than men in the same ethnicity categories. Moreover, women over the age of 50 years had a higher chance of death, with a progressive increment in risk as age increased.ConclusionsThere was a trend to worse prognosis in ALI emergencies associated with women, especially in older groups. The literature shows that the reasons for these differences are still poorly investigated and more robust studies of this relevant disease in the area of vascular surgery are encouraged.

Antimicrobial resistance of acinetobacter baumannii infection of lower respiratory tract and mortality – A cross-sectional study from a tertiary care teaching hospital in Kerala

Background: Acinetobacter baumannii has evolved as a common Multi Drug Resistant (MDR) microbe. This study was conducted to find the profile of antimicrobial resistance and mortality and their associated factors in A. baumannii infection of lower respiratory tract. Materials and Methods: This was a record based cross sectional study done in a tertiary care teaching hospital in Kerala. Records of all the 63, A. baumannii lower respiratory infection in 2017, were retrieved and analyzed. MDR was defined as resistance to at least one agent of three or more antimicrobial classes. Proportion of MDR, carbapenam resistance and resistance to other major antimicrobials were calculated. Determinants of carbapenam resistance and its associated antimicrobial resistance were explored. Proportion of mortality and the associated factors were explored. Student’s t-test, chi-square test or fisher exact test were used appropriately. Results: Proportions of MDR and carbapenam resistance were 85.7% and 41.3% respectively. Highest proportion (90.5%) was resistant to piperazillin-tazobactam. Carbapenam resistance was associated with MDR (p-value95% CI: 63.9% to 85.3%). Older age and ICU stay prior to infection were associated with mortality (p-value Conclusions: Rates of antimicrobial resistance in Acinetobacter baumannii and the mortality were high in the setting, comparable to reports from other parts of India. The drug resistance increases hospital care burden. There is an urgent need to implement stringent infection control measures. Keywords: Acinetobacter baumannii; Nosocomial infection; Antimicrobial resistance; Multi Drug Resistance; ESKAPE.

Clinical Profile of Mortality among Chronic Schizophrenic Patients: A Local Pilot Survey in Iran

Background: Many scholars believe that mental disorders may increase the risk of mortality among psychiatric patients in comparison with ordinary people. Unfortunately, since there is no systematic psychiatric case register system in Iran, a precise study of the rate of mortality of psychiatric patients in Iran is not easy. Objective: The objective of the current study included estimation of the rate of mortality and clinical profile of the died patients in a group of non-western aged schizophrenic patients. Methods: Senior section of Razi psychiatric hospital was selected as the specific field of investigation, and all elderly schizophrenic patients (≥65 years old), who had been hospitalized there, were nominated as the accessible sample and estimated with respect to the objectives of the present assessment. For survey, all deaths in the said district, which had occurred throughout the last sixty months (April of 2014-August 2019), had been listed by the supervisor of the mortality committee of the hospital. The clinical diagnosis was based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition, criteria. Results: Among 840 chronic elderly schizophrenic patients, 69 deaths were registered by the mortality committee of the hospital. As evident by the results, the annual rate of mortality among elderly schizophrenic patients in the present assessment was around 0.015 (0.15 per 1,000 individuals per year) and 0.017 (0.17 per 1,000 individuals per year) among male and female aged patients, respectively, which was significantly lower than the native crude death rate. While the average age of the expired female patients was significantly longer than male cases, the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Besides, while among the present sample of old schizophrenics cardiac disease was the main leading cause of death, other causes, like violence, suicide, road traffic accidents, falls, fires, drug use, tuberculosis, drowning, epilepsy, and Parkinson’s disease were not liable at all. Conclusion: While the rate of mortality among aged schizophrenics was significantly lower than the native crude death rate, the age of the expired female patients was significantly longer than the male cases and the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Cardiac disorder was the leading cause of death among the present sample of aged schizophrenics.

Mortalidade infantil entre indígenas no estado do Pará

Objetivo: Analisar o perfil de mortalidade infantil indígena. Método: Estudo epidemiológico, transversal realizado com 254 óbitos em crianças indígenas menores de um ano, notificadas ao Sistema de Informação da Atenção à Saúde Indígena, no estado do Pará, no período de 2013 a 2018. Resultados: Identificou-se proporção maior de óbitos em crianças do sexo masculino (53,9%; n=137), nas etnias Kaiapó (38,2%; n=97), Munduruku (27,6%; n=70) e Xicrim (13,8%; n=35). Os óbitos ocorreram nos hospitais (53,9%; n=137), e nos domicílios (24%; n=61), e as principais causas foram: as afecções perinatais (27,2%; n=69); as doenças do aparelho respiratório (18,9%; n=48), doenças infecciosas e parasitárias (15,7%; n=40). Conclusão: A mortalidade infantil indígena é mais elevada em algumas etnias, o que favorece ações de enfrentamento naquelas mais acometidas. É necessário a valorização da cultura indígena e o reconhecimento dos problemas socioeconômicos a serem contemplados num plano de ação para redução desse indicador.

OP513 Disparities In Cancer Premature Mortality In Brazil: Predictions Up To 2030 And Sustainable Development Goals

IntroductionPremature mortality affects the economy directly due to the loss of productivity of individuals who die, thus ceasing to contribute economically to the country. The one-third reduction in premature mortality (30–69 years) from chronic noncommunicable diseases is goal 3.4 of the United Nations Sustainable Development Goals (UN SDG). Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compared with the SDG 3.4 target and identify regional progress and future needs.MethodsMortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of one-third reduction of premature deaths.ResultsComparison of observed (2011–2015) and predicted (2026–2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6 percent among women nationally. Although predicted rates for 2026–2030 are lower than those observed in 2011–2015, the predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes.ConclusionsThe profile of cancer premature mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching the SDG 3.4 target, endorsing the government's long-term efforts to reduce tobacco consumption. Colorectal cancer mortality increases in most regions, reflecting the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge, especially in the North and Northeast. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in cancer patterns show the need to plan and to adapt regionally for each reality.

Mortality due to chronic non-communicable diseases: Scenario of Parnaíba – Piauí

Introduction: Chronic non-communicable diseases (NCDs) represent a huge obstacle to global health. In addition to causing economic impact on families and communities, they also cause many premature deaths, cause great restrictions and loss of quality of life. Objective: To portray the mortality profile due to chronic non-communicable diseases in the city of Parnaíba (PI) from 2016 to 2019. Methods: This is an ecological design of time series, with data collected from the Mortality Information System (SIM) of the Ministry of Health, between August and January 2020. Data that presented information from other municipalities were excluded. For data collection, version 3.6b of TABWIN, a program provided by DATASUS, was used. Data analysis was performed through the use of descriptive statistical analyses, including the whole number and percentage for non-communicable chronic diseases. Results and Discussion: Mortality rates, in the period from 2016 to 2019, due to NCDs present a high percentage of deaths for cardiovascular diseases (CVD), totaling 52.51%, followed by neoplasms (25.31%), diabetes mellitus (12.75%) and respiratory diseases, responsible for 9.43% of deaths. Conclusion: The study allowed the identification of a conformity of mortality rates between females and males, being higher in men in general, in the period studied, and that deaths from cardiovascular diseases total more than half of deaths from NCDs in the municipality of Parnaíba.

Coinfection with two strains of Photobacterium damselae subsp. damselae and Vibrio harveyi in cage farmed cobia, Rachycentron canadum (Linnaeus, 1766)

In the case of coinfections, multiple pathogens induce pathologies independently or in combination. The present study describes the pathological and microbiological characterization of Vibrio harveyi and two strains of Photobacterium damselae subsp. damselae causing coinfection in cobia reared in sea cages. All the isolated pathogens were virulent to juvenile cobia by injection challenge. The experimental challenge with the three isolated pathogens singly or in combination revealed a significant difference in the mortality profile. Lesions in natural coinfection consisted of ascites, fibrinous deposits on internal organs, and increased melanomacrophage centres (MMC) and extensive necrosis in kidneys. Lesions in experimental infection were limited to congestion of internal organs. Enzymatic activity of both extracellular products (ECP) and live cells by well diffusion showed the highest enzymatic index for gelatinase in the ECP of V. harveyi. The enzyme activity evaluated based on the API-ZYM system revealed the highest activity for alkaline and acid phosphatase in both ECP and bacteria. The MAR index indicated that the pathogens were from a low-risk region of antibiotic contamination.