Background and Objectives: Covid-19 can affect more than just the respiratory system, potentially leading to gastrointestinal dysfunction, including impaired intestinal motility and nutrient absorption, particularly in critically ill patients. The objective of this study was to estimate the prevalence of gastrointestinal (GI) manifestations and investigate their association with clinical outcomes among patients with Covid-19 hospitalized in the Intensive Care Unit (ICU) of a university hospital in the interior of Rio Grande do Sul, Brazil. Methods: This retrospective cohort study included 395 medical records of patients admitted to the ICU of a hospital in Santa Cruz do Sul, Brazil, between March 1, 2020, and June 30, 2021. Patients were identified using ICD-10 codes related to Covid-19. The presence of at least one documented gastrointestinal manifestation during the ICU stay was considered the primary exposure. The manifestations evaluated were diarrhea, nausea, vomiting, abdominal pain, abdominal distension, and constipation. Enteral nutrition was analyzed separately and was not considered a gastrointestinal manifestation. Results: Among the gastrointestinal manifestations evaluated, constipation was the most frequent (41.8%), followed by diarrhea (12.4%), abdominal distension (10.9%), abdominal pain (9.6%), nausea (5.3%), and vomiting (4.8%). The presence of gastrointestinal manifestations was not significantly associated with mortality or mechanical ventilation. However, it was associated with greater use of antibiotic therapy (OR 1.596; 95% CI 1.063–2.397; p = 0.024). Diarrhea was inversely associated with mortality and mechanical ventilation, while nausea was inversely associated with mortality. Conclusion: Gastrointestinal manifestations were frequent in patients with Covid-19 admitted to the ICU, and constipation was the most common manifestation. Although the overall presence of gastrointestinal manifestations was not significantly associated with mortality or mechanical ventilation, some individual manifestations showed associations with clinical outcomes. Despite its limitations, this study suggests that recognizing gastrointestinal manifestations early may help clinicians identify and manage them in critically ill patients.
Background and Objectives: Natural disasters expose populations to risk and highlight the need for effective prevention and response strategies. Following the floods that occurred in Rio Grande do Sul (RS), Brazil, in 2024, emergency outpatient clinics were established to address patients’ acute health complaints. The aim of this study was to describe the profile of patients treated and the medication prescribing patterns in an emergency outpatient clinic established during the 2024 floods. Methods: This was an observational, descriptive, retrospective, cross-sectional study with a quantitative approach, based on the analysis of 544 medical records from patients treated in Santa Cruz do Sul (RS), Brazil, between April and May 2024. Data were subjected to descriptive statistical analysis, considering sociodemographic characteristics, medical history, and therapeutic classes of prescribed medications. Results: There was a predominance of female patients and of adults and older adults among those receiving care. The most frequent clinical conditions were systemic arterial hypertension, diabetes mellitus, anxiety, and depression. Approximately half of the consultations did not result in medication prescription. Among the prescribed medications, analgesics were the most common, followed by psychotropic drugs, non-steroidal anti-inflammatory drugs, and antibiotics. The findings revealed a substantial demand related to the management of chronic conditions and mental health care, in addition to the healthcare needs traditionally associated with environmental disasters. Conclusion: It is concluded that the results reinforce the importance of intersectoral planning and health services prepared to act in climate emergencies, ensuring integrated responses, mitigating impacts, and strengthening community resilience.
Background and Objectives: Asthma is one of the most prevalent chronic respiratory diseases in the world and remains a significant public health problem due to its morbidity, socioeconomic impact, and risk of mortality in severe cases. This study aimed to analyze the temporal trends and sociodemographic patterns of asthma mortality in the state of Espírito Santo, Brazil, between 2010 and 2023. Methods: This is an ecological time-series study using data from the Mortality Information System (SIM/DATASUS) and population estimates from the Brazilian Institute of Geography and Statistics (IBGE). Sociodemographic variables and municipal socioeconomic indicators, such as the Human Development Index (HDI) and the Gini index, were analyzed. Temporal trends were assessed using Prais-Winsten regression to estimate the annual change in the number of asthma-related deaths. Results: A total of 829 asthma-related deaths were recorded during the study period (mean age: 63.9 years; 64.5% women). Most deaths occurred in a hospital setting (59.6%). Unspecified asthma (ICD-10 J45.9) accounted for 98.6% of cases. A significant increasing trend in the annual number of asthma deaths was observed, with an average absolute increase of 2.19 deaths per year (p = 0.001). Conclusion: Mortality from asthma showed an increasing trend in Espírito Santo, highlighting the need to strengthen preventive strategies, improve clinical management, and expand surveillance of respiratory diseases. The results also suggest the importance of public policies aimed at reducing inequalities and improving health information systems to minimize preventable deaths.
Background and Objectives: Tuberculosis is a public health problem, and Brazil aims to reduce the incidence rate of this disease to fewer than 10 cases per 100,000 inhabitants. This study aimed to analyze the trends in tuberculosis incidence, mortality and case fatality in the state of Paraná between 2018 and 2023. Methods: A time series study was conducted using secondary data from Paraná, Brazil, obtained through the Notifiable Diseases Information System. The incidence and mortality rates per 100,000 inhabitants and the case fatality rates—both overall and stratified by sex and age—were evaluated, as well as risk factors associated with death as an outcome. Trends were analyzed using linear regression and Prais–Winsten models, and risk factors were analyzed using the chi-square or Fisher’s exact test and relative risk. Results: Incidence, mortality, and overall case fatality rates for tuberculosis in Paraná remained stagnant. Stratified mortality, however, showed an upward trend among females (β=0.046; 95%CI=0.01, 0.09; p=0.042) and in the age group between 20 and 39 years (β=0.072; 95%CI=0.01, 0.14; p=0.043). Individuals experiencing homelessness (RR=4.25; 95%CI=3.46, 5.22; p<0.001), those who consumed alcohol (RR=2.32; 95%CI=2.00, 2.68; p<0.001), and those with comorbidities such as mental disorders (RR=2.02; 95%CI= 1.48, 2.76; p<0.001), diabetes mellitus (RR=1.88; 95%CI=1.52, 2.31; p<0.001), and other diseases (RR=2.30; 95%CI=1.93, 2.74; p<0.001) had a higher risk of death. Conclusions: The findings reveal a discrepancy between tuberculosis trends in Paraná and the goals set by Brazil’s National Plan to End Tuberculosis by 2030.
Background and Objectives: Despite advances in surgical techniques and preventive measures, surgical site infection remains prevalent, impacting patient recovery and generating substantial costs. Therefore, it is important to develop a study that identifies the most significant gaps in knowledge. This is justified by the high morbidity and mortality associated with postoperative infections, as reported in the literature, which represent a challenge for hospital systems. Its objective is to map the most effective measures in the literature and the areas in which scientific production is still insufficient, contributing to the improvement of institutional protocols and policies. Contents: A scoping review was conducted using the MEDLINE, Web of Science, SCOPUS, SciELO, and CINAHL databases, conducted in accordance with the methodology imposed by the Joanna Briggs Institute for scoping reviews and guided by the ten-step Preferred Reporting Items for Systematic reviews and Meta-analyses Scoping Review checklist. The data were analyzed in a double-blind process, considering the inclusion criteria as observational studies, both cross-sectional and longitudinal and primary, in addition to systematic reviews, available in full. Conclusion:Evidence-based strategies, combined with advanced technology and multidisciplinary approaches, have been shown to significantly reduce mortality rates, length of hospital stay, and the impact of long-term complications. In addition, the articles in the final sample highlighted important gaps that need to be studied over a longer period of time, focusing on studies in underdeveloped countries, post-discharge monitoring for the detection of late infections, and measurement of staff adherence to institutional protocols.
