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Brazil's health care system

Marina Amaral de Ávila de Machado, Alessandra Maciel Almeida, Adriana Maria Kakehasi, Francisco de Assis Acurcio
INTRODUCTION: In Brazil, patients with ankylosing spondylitis (AS) have access to free-of-charge comprehensive therapeutic care through the Brazilian National Health System. We collected prospective data on patients with AS receiving anti-tumor necrosis factor (anti-TNF) therapy through the Brazilian National Health System in Belo Horizonte City in order to evaluate the effectiveness, quality-of-life outcomes and safety of this therapy. METHODS: This was a prospective study that included 87 patients receiving their first course of anti-TNF agents (adalimumab, etanercept or infliximab)...
June 2016: Rheumatol Ther
Raquel Rodrigues Barbieri, Anna Maria Sales, Mariana Andrea Hacker, José Augusto da Costa Nery, Nádia Cristina Duppre, Alice de Miranda Machado, Milton Ozório Moraes, Euzenir Nunes Sarno
OBJECTIVE: We evaluated the profile of patients referred to the Fiocruz Outpatient Clinic, a reference center for the diagnosis and treatment of leprosy in Rio de Janeiro, RJ, and analyzed the origins and outcomes of these referrals. METHODS: This is an observational retrospective study based on information collected from the Leprosy Laboratory database at Fiocruz, Rio de Janeiro, RJ, Brazil. A total of 1,845 suspected leprosy cases examined at the reference center between 2010 and 2014 were included...
October 2016: PLoS Neglected Tropical Diseases
Suzely As Moimaz, Najara B Rocha, Artênio Ji Garbin, Cléa As Garbin, Orlando Saliba
This study evaluated the relationships between oral conditions and oral health-related quality of life (OHRQoL), as well as related factors. A crosssectional study was performed on 119 postnatal women who had sought prenatal care during pregnancy in the public health system of São Paulo State, Brazil. The women received oral clinical exams and were interviewed using the questions on the OHIP14. A second survey with information about their socioeconomic status, pregnancy and health habits was administered. The highest OHIP14 scores were found in the area of physical pain, with an average score of 10...
September 2016: Acta Odontológica Latinoamericana: AOL
David S Younger
A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines...
November 2016: Neurologic Clinics
Luana Sicuro Correa, Yara Hahr Marques Hökerberg, Raquel de Vasconcellos Carvalhaes de Oliveira, Danielle Martins de Souza Barros, Helenara Abadia Ferreira Alexandria, Regina Paiva Daumas, Carlos Augusto Ferreira de Andrade, Sonia Regina Lambert Passos, Patrícia Brasil
OBJECTIVE: The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. METHODS: Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0...
2016: PloS One
Janaina Melo, Adriana Moreno, Virginia Ferriani, Ana Carla Araujo, Elcio Vianna, Marcos Borges, Pérsio Roxo, Marcos Gonçalves, Luane Mello, Rosa Parreira, Jorgete Silva, Patricia Stefanelli, Larissa Panazolo, Andrea Cetlin, Luana Queiroz, Rosângela Araujo, Marina Dias, Davi Aragon, Nélio Domingos, L Karla Arruda
OBJECTIVE: Asthma is under-diagnosed in many parts of the world. We aimed to assess the outcome of a capacitating program on asthma for non-specialist physicians and other healthcare professionals working in the public health system in Ribeirão Preto, Brazil. METHODS: A group of 16 asthma specialists developed a one-year capacitating program in 11 healthcare clinics in the Northern District of the city, which included lectures on asthma, training on inhalation device use and spirometry, and development of an asthma management protocol...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Cláudia de Brito, Margareth Crisóstomo Portela, Mauricio Teixeira Leite de Vasconcellos
Objectives To better understand the role that health care plays in breast cancer survival by investigating the effects that hormone therapy adherence and other select health care variables, adjusted for clinical and sociodemographic factors, had among a population of women in Rio de Janeiro, Brazil. Methods This was a longitudinal study based on secondary data of 5 861 women treated with hormone therapy (tamoxifen or aromatase inhibitors) at the National Cancer Institute of Brazil (INCA), from 1 January 2004 - 29 October 2010...
June 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Lauren Arnesen, Pablo Durán, Juan Silva, Luisa Brumana
Objective To consolidate available information from the Latin American and Caribbean (LAC) region on 1) national incidence of retinopathy of prematurity (ROP) and 2) national-level government inputs on ROP (existing national policies, guidelines, programs, and financing for ROP prevention, detection, and treatment, including ROP screening) in 2014. Methods In March and April 2015, a multi-country online survey was distributed to 56 medical and public health experts working on ROP in LAC countries. Respondents were instructed to provide quantitative and qualitative information representative of the national situation in 2014 for ROP incidence and national-level government inputs (existing national policies, guidelines, programs, and financing for ROP prevention, detection, and treatment, including ROP screening) in their country...
June 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Christiane Maia, Dirce Guilhem
Objective To outline and discuss the main challenges for sanitary regulation contained in the federal-level Brazilian health policy. Methods For the present qualitative study, based on the analysis of public policies, information was collected from documents and interviews. Document analysis provided a historical overview of the insertion of sanitary regulation into the Brazilian health policy between 1999 and 2009 (first decade of existence of the national health surveillance agency, Anvisa). In addition, 13 interviews were carried out with actors selected for their historical, technical, or academic role in the field...
May 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Marcelo Araújo de Freitas, Angélica Espinosa Miranda, Ana Roberta Pati Pascom, Silvano Barbosa de Oliveira, Fabio Mesquita, Nathan Ford
OBJECTIVE: To describe the antiretroviral therapy status of people living with HIV (PLHIV) who died of AIDS-related causes between 2009 and 2013. METHODS: We conducted a cross-sectional, population-based study. Data were obtained by linking the mortality information system and the national ART dispensing database. Trends were modelled using linear regression analysis. RESULTS: A total of 61 425 AIDS-related deaths were registered in Brazil between 2009 and 2013...
October 3, 2016: Tropical Medicine & International Health: TM & IH
Alex Magno Coelho Horimoto, Erica Naomi Naka Matos, Márcio Reis da Costa, Fernanda Takahashi, Marcelo Cruz Rezende, Letícia Barrios Kanomata, Elisangela Possebon Pradebon Locatelli, Leandro Tavares Finotti, Flávia Kamy Maciel Maegawa, Rosa Maria Ribeiro Rondon, Natália Pereira Machado, Flávia Midori Arakaki Ayres Tavares do Couto, Túlia Peixoto Alves de Figueiredo, Raphael Antonio Ovidio, Izaias Pereira da Costa
INTRODUCTION: Systemic sclerosis (SSc) is an autoimmune disease which shows extreme heterogeneity in its clinical presentation and that follows a variable and unpredictable course. Although some discrepancies in the incidence and prevalence rates between geographical regions may reflect methodological differences in the definition and verification of cases, they may also reflect true local differences. OBJECTIVES: To determine the prevalence and incidence of SSc in the city of Campo Grande, state capital of Mato Grosso do Sul (MS), Brazil, during the period from January to December 2014...
September 17, 2016: Revista Brasileira de Reumatologia
Raman Kumar, Ana Nunes Barata, Mayara Floss
This opinion paper is a collaborative effort describing recent developments in primary care education in three different countries; representing diverse socioeconomic and political systems. The authors describe their respective perspectives from the point of student (Brazil), trainee (Portugal) and young doctor (India). The section on Brazil focuses on the response of the medical education system to the developments before and after political reforms, leading to creation of the Unified Health System. The Indian experience focuses on the challenges faced by recently qualified doctors and ongoing debates about the medical education system in a highly populated but rapidly growing economy...
September 2016: Education for Primary Care
Francisco J Mercado-Martinez, Denise Guerreiro V da Silva, Mauricio E Correa-Mauricio
Renal replacement therapy is the indicated treatment for individuals with chronic kidney disease (CKD) to survive. However, not all sick people have access to the same treatment. This study compares renal care in two developing countries with different health systems. Specifically, it explores hemodialysis treatment from the perspective of low-income individuals. A qualitative, comparative study was performed in Brazil and Mexico. Using purposive sampling, the research was based on open-ended interviews with nineteen participants with kidney failure undergoing hemodialysis treatment in public hospitals and ten relatives...
September 27, 2016: Nursing Inquiry
Manoel Sarno, Marcelo Aquino, Kleber Pimentel, Renata Cabral, Gisela Costa, Fernanda Bastos, Carlos Brites
OBJECTIVE: Our aim was to describe the pattern and progression of Central Nervous System (CNS) lesions of microcephalic fetuses with suspected Zika Virus (ZIKV) infection. METHODS: We analyzed fetuses diagnosed with microcephaly after a routine primary care ultrasound scan suspect a fetal microcephaly in Salvador, Brazil, from July/2015 to February/2016 and these pregnancies were followed until delivery. Microcephaly was diagnosed when the head circumference was below two or more standard deviation for gestational age and its relationship with ZIKV infection was defined according to World Health Organization criteria...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
William L Walker, Nicole P Lindsey, Jennifer A Lehman, Elisabeth R Krow-Lucal, Ingrid B Rabe, Susan L Hills, Stacey W Martin, Marc Fischer, J Erin Staples
Zika virus is a mosquito-borne flavivirus primarily transmitted to humans by Aedes aegypti mosquitoes (1). Zika virus infections have also been documented through intrauterine transmission resulting in congenital infection; intrapartum transmission from a viremic mother to her newborn; sexual transmission; blood transfusion; and laboratory exposure (1-5). Most Zika virus infections are asymptomatic (1,6). Clinical illness, when it occurs, is generally mild and characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis...
September 16, 2016: MMWR. Morbidity and Mortality Weekly Report
Marcos F Mello, Giovanni Scala Marchini, Cesar Câmara, Alexandre Danilovic, Renata Levy, José Eluf-Neto, Miguel Srougi, Eduardo Mazzucchi
PURPOSE: To assess the public hospitalization rate due to stone disease in a large developing nation for a 15-year period and its association with socio-demographic data. MATERIALS AND METHODS: A retrospective database analysis of hospitalization rates in the Brazilian public health system was performed, searching for records with a diagnosis code of renal/ureteral calculi at admission between 1998-2012. Patients managed in an outpatient basis or private care were excluded...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Robsmeire Calvo Melo Zurita, Emiliana Cristina Melo, Rosana Rosseto de Oliveira, Maria do Rosário Dias de Oliveira Latorre, Thais Aidar de Freitas Mathias
OBJECTIVE: To analyse the trend of expenditure on drug-related psychiatric hospital admissions in Maringá, Paraná, Brazil, from 1999 to 2012. METHOD: Ecological time series research with secondary data from the hospital information system of the unified health system ("SIH-SUS"). The records of admissions with a main diagnosis of drug abuse were used to calculate average expenditure. Chapter V of the ICD-10 was used to classify the most frequent diagnoses, namely abuse of alcohol, cannabis, cocaine, and psychoactive substances...
September 2016: Revista Gaúcha de Enfermagem
Fátima Aparecida Lotufo, Mary Angela Parpinelli, Maria José Osis, Fernanda Garanhani Surita, Maria Laura Costa, José Guilherme Cecatti
BACKGROUND: Eclampsia is the main cause of maternal death in Brazil. Magnesium sulfate is the drug of choice for seizure prevention and control in the management of severe preeclampsia and eclampsia. Despite scientific evidence demonstrating its effectiveness and safety, there have been delays in managing hypertensive disorders, including timely access to magnesium sulfate. To conduct a general situational analysis on availability and use of magnesium sulfate for severe preeclampsia and eclampsia in the public health system...
2016: BMC Pregnancy and Childbirth
Joao H G Sa, Marina S Rebelo, Alexandra Brentani, Sandra J F E Grisi, Leonardo H Iwaya, Marcos A Simplicio, Tereza C M B Carvalho, Marco A Gutierrez
INTRODUCTION: Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning...
October 2016: International Journal of Medical Informatics
Rosemary Costa Pinto, Daniel Barros de Castro, Bernardino Cláudio de Albuquerque, Vanderson de Souza Sampaio, Ricardo Augusto Dos Passos, Cristiano Fernandes da Costa, Megumi Sadahiro, José Ueleres Braga
Dengue is a major public health problem in tropical and subtropical areas worldwide. There is a lack of information on the risk factors for death due to severe dengue fever in developing countries, including Brazil where the state of Amazonas is located. This knowledge is important for decision making and the implementation of effective measures for patient care. This study aimed to identify factors associated with death among patients with severe dengue, in Amazonas from 2001 to 2013. We conducted a retrospective cohort study based on secondary data from the epidemiological surveillance of dengue provided by the Fundação de Vigilância em Saúde do Amazonas, FVS (Health Surveillance Foundation) of the Secretaria de Saúde do Amazonas, SUSAM (Health Secretariat of the State of Amazonas)...
2016: PloS One
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