Cardiovascular diseases are among the leading causes of morbidity and mortality in Brazil, with acute myocardial infarction (AMI) and stroke standing out as time-dependent emergencies whose clinical outcomes are directly influenced by the quality and promptness of initial care. In the state of Goiás, there has been a progressive increase in the demand for emergency services, reinforcing the importance of analyzing hospital service organization and the role of the Emergency Medicine specialist. This study aims to quantify the occurrence of major cardiovascular events in the state over the past ten years and to investigate the relationship between the presence of an emergency physician and care indicators related to morbidity and mortality. This is a retrospective, observational, and analytical study using secondary data from the Brazilian Unified Health System Hospital Information System (SIH/SUS), complemented by a narrative literature review. The time frame includes the period from 2015 to 2024, encompassing cases treated in urgent and emergency services with a diagnosis of AMI or stroke. Indicators such as mortality rates, critical care time intervals, and organization of care pathways will be analyzed, considering the influence of medical specialization on initial management. The discussion will address the role of Emergency Medicine in reducing therapeutic delays, managing time-dependent conditions, and improving clinical outcomes, highlighting its implications for strengthening the Emergency Care Network and informing public health policies.

Gastric cancer is a highly lethal malignancy with substantial regional variability in Brazil. Understanding mortality patterns is essential to guide public health strategies. This study aimed to analyze the epidemiological profile of deaths from gastric cancer in Brazil between 2014 and 2023. This was an observational, analytical, ecological study that assessed deaths from malignant neoplasms of the stomach using data from the Mortality Information System (SIM/DATASUS). Variables included region, sex, age group, and race. Crude mortality rates per 100,000 inhabitants were calculated, and statistical analyses were performed using Welch’s ANOVA and chi-square tests (p<0.05). A total of 144,405 deaths were recorded. The Southeast and South regions accounted for the highest numbers, while the Northeast and Central-West had the lowest. Mortality increased with age, predominantly affecting individuals aged 60 years or older. Men represented 63.76% of deaths, and racial distribution mirrored population composition, with White and Brown individuals comprising the majority. Regional mortality rates differed significantly (p<0.0001), with the South showing the highest peak and the Central-West the lowest. It is concluded that gastric cancer mortality in Brazil is heterogeneous, influenced by age, sex, and socioeconomic factors, highlighting the need for public health policies focused on prevention, early diagnosis, and equitable healthcare access.

BackgroundIn Brazil, 1.2 million people are living with Alzheimer's Disease (AD), according to the Brazilian Alzheimer's Association and the Brazilian Hospital Services Company, and approximately 100.000 new cases are diagnosed per year. In this context, analyzing the distribution of AD‐related deaths is essential for shaping public health policies. Therefore, this study seeks to compare Brazilian public health data on AD, examining the age and gender distribution of AD‐related deaths from 2020 to 2023.MethodThis is a cross‐sectional study of epidemiological data on AD mortality in the Brazilian population between 2020 and 2023. The data, obtained from the Information Technology Department of the Unified Health System, were stratified by gender and age groups (40–49, 50–59, 60–69, 70–79, and 80 or older).ResultFrom 2020 to 2023, 108.768 deaths were attributed to AD and to AD Related Dementia (ADRD). Approximately 77% of them occurred in individuals aged 80. Throughout that period, there was a fivefold increase in mortality among females when compared those aged 80 and older to the 70‐79 age group. There was only a 2.87‐fold increase in the same age group among males. In the 60 to 69 age group, the mortality ratio of women to men was only 1.03, which reveals a minimal difference between them. However, considering the age groups over 70, the ratio rises to 1.88, reinforcing that, in older age, women are at higher risk of dying of AD and ADRD.ConclusionBrazil, following the global trend, registered increasing mortality rates due to AD and ADRD. The results, aligned with previous findings, reveal that females aged 70 or older face the highest risk of dying of AD. The available data are insufficient to determine whether the increased mortality of women aged 80 or older is attributable to a greater probability of AD development or to a tendency to experience more severe forms of the disease when it is diagnosed. Thus, enhancing the public statistical data system is essential to support effective public health policies, especially because, as observed here, AD represents a significant burden of disease, death and disability.

Cardiovascular diseases represent the leading cause of hospitalizations and mortality in Brazil, particularly affecting vulnerable populations and increasing the complexity of care during the postoperative cardiac period. In this context, dysphagia emerges as a frequent complication after invasive procedures, with the potential to prolong hospitalization and increase adverse outcomes, making the role of the speech-language pathologist essential in evaluating and rehabilitating these patients alongside a multiprofessional team. Thus, the present study aims to verify the effectiveness of the institutionalized protocol regarding the timing of oral intake initiation, as well as to assess the efficacy of standardized actions for the introduction of oral feeding in patients. This is a prospective, cross-sectional, quantitative, descriptive, documentary field study conducted in the Coronary Unit of the Hospital de Clínicas Gaspar Vianna, analyzing 50 medical records of patients who underwent cardiac surgery between September and October 2025. The data were organized into spreadsheets and submitted to descriptive statistical analysis, including Fisher’s Exact Test. The early extubation protocol demonstrated effectiveness, with 98% of patients extubated in less than 24 hours achieving the extubation goal within 6 hours. Oral intake was initiated in 98% of cases, mostly in a semi-liquid consistency. Earlier direct evaluations favored safe feeding introduction. Thus, the institutional protocol proved effective in reintroducing oral feeding, ensuring safety and a higher likelihood of early oral intake. The standardization of procedures and the work of the speech-language pathologist and the multiprofessional team contribute to the clinical progression of patients.

Head and neck cancer mortality by gender, region and ethnicity: a population-based study in Brazil

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease with increasing clinical and epidemiological relevance. While global mortality trends have been well documented, long-term national-level data from middle-income countries are limited. This study aimed to characterize IPF-related mortality in Brazil over a 28-year period and to estimate national prevalence, incidence, and future trends.MethodsWe conducted a retrospective, population-based analysis of national mortality data from Brazil’s public health system (DATASUS) from 1996 to 2023. IPF-related deaths were identified using ICD-10 code J84.1. Mortality trends were stratified by sex, ethnicity, and age. Odds ratios (ORs) by sex were calculated annually. IPF prevalence and incidence in 2023 were estimated using survival-based modeling (3–10 years), and linear projections were used to forecast mortality trends through 2028.ResultsA total of 61,518 IPF-related deaths were recorded. Annual deaths increased from 1,021 in 1996 to 3,778 in 2023, with an average annual growth of 5.2%, surpassing trends in respiratory (2.5%) and all-cause mortality (1.9%). Most deaths occurred in individuals aged ≥70 years (69%), and 67.4% were among White individuals. Although absolute mortality was slightly higher among females, men had consistently higher odds of IPF-related death (OR range, 1.03–1.54). Estimated IPF prevalence in 2023 ranged from 9,800 to 30,900 individuals, depending on survival assumptions. Projections indicate continued increases in mortality through 2028.ConclusionsIPF-related mortality in Brazil has more than tripled since 1996, reflecting both improved diagnostic capacity and population aging. However, demographic disparities by sex and ethnicity persist. These findings underscore the urgent need to strengthen national disease registries, expand early diagnostic programs, and improve access to antifibrotic therapy to address the growing burden of IPF in Brazil.

Introduction: Breast cancer ranks among the leading causes of female mortality in Brazil and worldwide, and is considered a serious public health challenge. Through a literature review, this study seeks to assess the relevance of prevention strategies and early diagnosis, emphasizing the critical role of nursing professionals and the contribution of public policies in early detection of the disease. Scientific articles, specialized publications, and case studies published between 2015 and 2025 were consulted, including systematic reviews, narratives, and experience reports. The data revealed that mammography remains the most efficient screening method, although barriers to access are still observed in different regions and among different social groups. The impact of ongoing educational activities conducted by multidisciplinary teams, with a special focus on nurses, was also highlighted as an indispensable approach to strengthening primary care and encouraging self-care among women. At the same time, the use of digital technologies, such as telemedicine, has expanded the reach of early diagnosis programs, especially in remote areas. In conclusion, the effectiveness of breast cancer prevention and screening actions is intrinsically linked to the integration of efforts in health education, technological innovation, and lasting public policies that guarantee equitable, accessible, and humane care for women.

Ischemic stroke represents one of the leading causes of morbidity and mortality in Brazil and worldwide, and intervention within the therapeutic window is crucial to reduce sequelae and deaths. This study aimed to analyze, through an integrative literature review, the scientific evidence on interventions and treatments for ischemic stroke, focusing on the nursing role. Fifteen articles published between 2012 and 2025 were selected from databases such as SciELO, LILACS, PubMed, and BVS, following clearly defined inclusion and exclusion criteria. The results were organized into six main categories: fundamentals of nursing knowledge and competencies in thrombolysis; systematization and protocols for optimizing in-hospital care; systemic barriers and factors associated with delayed treatment; advanced interventions and complication management; the panorama of nursing practice in the Brazilian hospital context; and future perspectives and innovations in ischemic stroke management. The analysis showed that continuous nursing education, the use of standardized clinical protocols, and the incorporation of emerging technologies, such as telemedicine and artificial intelligence, are essential to improve the effectiveness of time-dependent therapies. It is concluded that nursing practice plays a decisive role both in hospital care and in health education and prevention, consolidating itself as a key element to reduce the impact of ischemic stroke on the population.

Background: Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. Objectives: This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. Methods: A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ2) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. Results: A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. Conclusions: Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice.

Effects of ambient temperature on under-five mortality: a nationwide space-time-stratified case-crossover study in Brazil.

Spatio-temporal clustering analysis, temporal trends, and inequality in oral and oropharyngeal cancer mortality in Brazil over 44 years (1980-2023).

Lung cancer remains a leading cause of cancer mortality in Brazil, with non-small cell lung cancer (NSCLC) accounting for 85% of cases, with 1.6% carrying epidermal growth factor receptor (EGFR) exon 20 mutations. In the phase I CHRYSALIS trial (ClinicalTrials.gov identifier: NCT02609776), amivantamab demonstrated a median overall survival (OS) of 22.8 months versus 8.3 months with docetaxel, the standard second-line Brazil's Unified Health System (SUS) therapy. Although the Brazilian Health Regulatory Agency approved amivantamab, the National Commission for the Incorporation of Technologies' cost-effectiveness reviews result in an average 10-year delay before SUS incorporation. We aimed to estimate premature deaths and life-years lost attributable to this access gap. Using National Institute of Cancer (INCA) data, we estimated SUS-eligible patients, NSCLC prevalence, and EGFR exon 20 frequency. Stage distribution and 5-year recurrence rates identify candidates for amivantamab. A hazard ratio (HR) was derived from the inverse exponential method (ln(2)/OS ratio). Preventable deaths were calculated as: eligible patients × (1 - HR). Life-years gained per patient were estimated as OS difference. Of the 26,548 new patients with lung cancer, 18,973 are SUS-eligible, 16,127 have NSCLC, and 258 have EGFR exon 20 mutations. Metastatic disease accounts for 114, whereas recurrences occur in 60 (stage III), eight (II), and four (I), totaling 186 candidates annually. With an HR of 0.364, the annual preventable death in the base-case scenario is equal to 186 × (1 - 0.364) × 95% = 112 patients. Over 10 years, 1,120 premature deaths and 1,353 life-years could be avoided. Delayed SUS incorporation of amivantamab may result in over a 1,000 preventable deaths and life-years lost among Brazilian EGFR exon 20-mutated NSCLC. Urgent real-world studies and cost-effectiveness analyses are needed.

BackgroundThe simultaneous COVID-19 and HIV/AIDS pandemics have created unprecedented challenges, disrupting healthcare for people living with HIV/AIDS (PLWHA) and introducing an additional lethal threat. However, the impact of COVID-19 among PLWHA in Brazil remains unclear. We aimed to investigate the association between HIV infection and COVID-19 mortality in the Brazilian population.MethodsA multilevel study was conducted using data from the Brazilian Mortality Information System. We examined COVID-19 mortality among individuals with and without mention of HIV on their death certificates from 2020 to 2022. Mixed generalized linear regression models were used, considering the COVID-19 dominant Variant of Concern (VOC) and the vaccine rollout period, adjusted for age group and sex, interaction between HIV and age group, and random effects for federative units.ResultsA total of 4,773,337 deaths were analyzed, including 39,011 among PLWHA. Younger (18–39) and older (80+) PLWHA had higher odds of COVID-19 death, particularly during Delta and Omicron periods. Mortality odds among PLWHA were lower during the vaccination expansion phase but increased during the consolidated phase. Regional disparities were observed, with higher mortality odds in Northern and Northeastern Brazil.ConclusionsHIV infection was associated with higher COVID-19 mortality in Brazil, particularly in specific age groups and regions. Older adults with HIV had an elevated risk of COVID-19 death across all periods. The vaccine rollout reduced COVID-19 mortality among PLWHA, but the results did not hold over time, as evidenced by the increased odds of death in all age groups following vaccination coverage consolidation in the population. Supplementary InformationThe online version contains supplementary material available at 10.1186/s12981-025-00759-z.

Non-Communicable Chronic Diseases (NCDs) are among the leading causes of morbidity and mortality in Brazil, significantly affecting quality of life and overburdening the healthcare system. This study aimed to discuss, through an integrative literature review, the role of nurses in caring for patients with NCDs within Primary Health Care (PHC). The research was conducted in well-established databases such as SciELO, BVS, CAPES, and Google Scholar, covering studies published between 2020 and 2025. Out of 159 initially identified articles, 10 were selected based on inclusion criteria. The findings highlighted the central role of nurses in managing NCDs, particularly through health education, home visits, clinical monitoring, and the promotion of self-care. The study underscored the importance of health education, the use of technologies, and care integration across healthcare levels for the successful management of these conditions. It is concluded that strengthening the role of nurses in PHC, supported by public policies focused on professional development and ongoing training, is vital for effective care and improved health outcomes.

Introduction: Chronic noncommunicable diseases (NCDs), such as systemic arterial hypertension (SAH) and diabetes mellitus (DM), represent important causes of morbidity and mortality in Brazil, with a greater impact on vulnerable populations. Low adherence to treatment, combined with misinformation, cultural beliefs, and access barriers, worsens the clinical picture and increases the risk of complications. Experience Report: The intervention was carried out in May 2025, in a social housing complex in the municipality of Mafra, Santa Catarina, by two students and a professor from the Medical School at the Universidade do Contestado, affiliated with the Academic Merit Credit Program. The activity consisted of blood pressure measurements, simplified medical history taking, and guidance on lifestyle habits and proper medication use, based on national guidelines. Discussion: Low therapeutic adherence was observed through residents' reports, where they reported using continuous medications inappropriately, impacting blood pressure and capillary blood glucose levels at the time, where their practice is influenced by the perception that the absence of symptoms would indicate disease control. The intervention, conducted in accessible language appropriate to the local context, helped demystify information, encourage self-care, and strengthen community ties. Conclusion: The experience reinforces the relevance of extension actions as effective health education strategies, capable of promoting the prevention of NCDs and strengthening the role of universities in primary care, integrating health promotion, community ties, and continuous care.

Abstract Background Among causes of death, cardiovascular diseases do not represent a homogenous group. Social inequalities impact cardiovascular mortality in different ways when comparing ischemic heart diseases (IHD) and stroke and between different territories and population groups, considering their socioeconomic indicators. In this study, we aim to evaluate temporal trends from IHD and stroke mortality in Brazilian states. Methods We used data from Brazil at a sub-national level from 1996 to 2019, collected from the Global Burden of Disease (GBD) database, to accomplish the analysis. We calculated age-adjusted mortality rates and analyzed cardiovascular diseases, and then ischemic heart diseases and cerebrovascular diseases. We applied a time series analysis using joinpoint regression and we calculated annual percentage change. Results Brazil shows a long term declining trend for cerebrovascular diseases and ischemic heart disease. In both groups, there is a recent change in decreasing in adjusted mortality rates, varying in a subnational level. For cerebrovascular diseases, the reduction period occurs from 2014 (APC = -1.4, CI 95% -2.0 to -0.7). For ischemic heart diseases, the inflection occurs from 2005 (APC = -1.9, CI 95% -2.0 to -1.8). The proportional mortality for IHD is predominant among the states. There is no pattern to which we can relate development or spatial distribution between regions. We observed irregular trends for IHD mortality in 13 of the 27 states, where almost all of them had two inflection points. On the other hand, the trends in stroke mortality were irregular in most of the federal units, with the majority also showing two inflection points. Conclusion The great heterogeneity between states requires special attention to deal with this change in mortality pattern. Policies for public health must consider the diversity levels in health and in socioeconomical development between Brazilian states.

Bicycles are common mode of transport in countries with well-developed road infrastructure and traffic law enforcement. In Brazil, their use for economic activities, particularly on app-based deliveries, has surged. However, work-related cyclist fatalities (WRCFs) remain an understudied public health concern. This study characterizes WRCFs among individuals aged 10-69 in Brazil from 2014 to 2022, analyzing key demographic, occupational, temporal, and geographic trends. Using data from Brazil's Mortality Information System (MIS), we examined deaths classified under ICD-10 codes V10-V19 (pedal cyclist injured in transport accidents). Proportional mortality, mean age at death (MAoD), median, interquartile range and Years of Potential Life Lost (YPLL) were calculated. Of 6590 cyclist-related fatalities, 272 (4.1%) were confirmed as WRCFs. Most victims were male (87.1%), aged 29-58years (68.3%), white (49.7%), had low education levels (< 12years, 82.4%) and were single (45.9%). Fatalities seem concentrated in the South/Southeast regions (71%), with 61.3% involving collisions with motor vehicles (ICD-10 codes V13-V14). The highest proportions of WRCFs occurred among industrial (42%) and sales/trade (30.9%) workers. The MAoD was 43.6years, with a total of 8896.4 YPLL. Notably, work-related fatality classification was missing in 57% of cases, highlighting the need for improved death certificate reporting in the country. Enhancing data quality is essential to understanding the risks faced by workers, many of whom are engaged in precarious, informal employment without social protection.

The X-linked TLR7 rs179008 T allele has been associated with altered antiviral immunity. Given their shared inflammatory pathways and higher pediatric mortality rates in Brazil during the pandemic, we investigated their association with multisystem inflammatory syndrome in children (MIS-C) together with Kawasaki disease (KS) following SARS-CoV-2 infection. A cross-sectional study (2021–2022) analyzed 73 hospitalized children (<13 years) with confirmed COVID-19. Genotyping for TLR7 rs179008, TLR8 (rs3764879, rs2407992), and TLR3 rs3775291 was performed via PCR and Sanger sequencing. MIS-C/KS cases were identified using CDC criteria, with severity classified by the need for ICU care. Statistical analysis included Fisher’s exact test and relative risk (RR) calculations. Hemizygous boys carrying the TLR7 T allele had a 1.87-fold higher risk of MIS-C/KS (p = 0.007) and a 1.75-fold increased risk of severe or critical outcomes. The T allele frequency was 2.6× higher in MIS-C/KS cases versus other COVID-19 presentations. All fatalities occurred in boys (3/8 MIS-C cases) with one T-allele carrier. No associations were found for TLR8 or TLR3 variants. The TLR7 rs179008 T allele is a potential genetic risk factor for severe post-COVID-19 inflammatory syndromes in boys, likely due to impaired immune signaling. These findings highlight its utility as a biomarker for risk stratification in pediatric populations.

Epidemiology and Economic Burden of Suicide Among Brazilian Workers: Trends, Occupational Disparities, and Gender Differences.

Early life conditions are associated with later life health. However, research in this area has been based on high-income countries, with limited research in low- and middle-income countries. We examine how childhood conditions are associated with mortality in older adulthood in the United States and Brazil, while evaluating the role of educational attainment and gender differences. Data come from the HRS and ELSI-Brazil. We use structural equation modeling to examine direct and indirect pathways from childhood conditions to mortality in older adulthood for men and women. Results showed substantial differences between Brazil and the United States. Childhood health was associated with increased mortality risk in the United States, not in Brazil. Adverse childhood conditions were associated with increased mortality in Brazil and the United States, but we found a large indirect pathway through educational attainment in the UNITED STATES Lastly, we found notable gender differences across both countries, with indirect pathways for UNITED STATES men and Brazilian women (not their counterparts). Findings point to the malleability of the association of childhood conditions on adulthood mortality risk. Future work should consider how exposures and opportunities combine to influence life course developments of health and aging processes in diverse populations.