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BACKGROUND: Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic. DESIGN AND SETTING: This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states. METHODS: Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020. RESULTS: A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month. CONCLUSION: The pandemic caused a negative impact on meningitis notifications in Brazil.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in Brazil, several government policies have been taken. Herein, we aimed to assess the impact of the COVID-19 pandemic on hospital admissions and in-hospital lethality for cardiovascular diseases (CVD) in Brazil in 2020. An ecological and time-series study on hospitalizations and deaths from CVD in Brazil was conducted from January 2018 to December 2020.The hospital admission rate for CVD reduced by 17.1%, with a significant decreasing trend between January and May 2020 (Annual Percent Change: -8,7%; P-value0.001). The in-hospital lethality rate increased from 8.2% in 2018 to 9.3% in 2020. During this period, Brazil totaled 21.8 million days of hospital stay. Indicators of hospital admissions and lethality from CVD in Brazil were impacted by the emergence of the COVID-19 pandemic in different ways in the regions and depending on the nature of the indicator.

The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units.Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020).This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level.There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: -1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions.There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset.A pandemia da COVID-19 tem causado um impacto sobre a mortalidade por várias doenças em todo o mundo, especialmente por doenças cardiovasculares (DCVs). O Brasil é um país de dimensões continentais com diferenças significativas na estrutura de saúde entre seus estados.Analisar a mortalidade hospitalar por DCV no sistema público de saúde durante o primeiro ano da pandemia por COVID-19 (2020) no Brasil.Este é um estudo ecológico analisando o número absoluto de mortes hospitalares e a taxa de mortalidade hospitalar no Brasil, suas macrorregiões, e unidades federativas. Os dados foram obtidos do Sistema de Informações Hospitalares (SIH) do Ministério da Saúde. O P-escore foi usado para analisar o excesso de mortalidade. O escore compara os eventos observados com os eventos esperados para um dado local e período. O escore-P foi corrigido por um modelo de regressão joinpoint, com um intervalo de confiança de 95% e nível de significância de 5%.Houve 93.104 óbitos hospitalares por DCV no Brasil em 2020, o que representa 1495 menos óbitos (escore-P: -1,58) que o esperado. A região centro-oeste apresentou um escore-P positivo, com um aumento de 15,1% no número de mortes. Dez estados apresentaram um maior número de óbitos em 2020. Ainda, observou-se um excesso de 13,3% de mortalidade hospitalar no país como um todo, e um excesso de mortalidade hospitalar em todas as macrorregiões.Houve uma diminuição no número absoluto de óbitos hospitalares, bem como um aumento na taxa de mortalidade por DCV no Brasil em 2020, após o início da pandemia por COVID-19.

Background: Leprosy is a neglected, chronic and infectious tropical disease, caused by Mycobacterium leprae. It presents with skin and peripheral nerves alterations, responsible for irreversible physical disabilities. Brazil is one of the main countries endemic for the disease, persisting as a public health problem; its position is the first in the world in terms of prevalence coefficient. Objectives: To analyze the magnitude and factors associated with activity limitation in new leprosy cases diagnosed in the reference center in northeastern Brazil. Methods: This is a cross-sectional study, carried out in a reference center located in the municipality of Juazeiro - Bahia, between January and June 2018, involving 50 people diagnosed with leprosy. Clinical and sociodemographic variables were collected in addition to the application of the SALSA scale (Screening of Activity Limitation and Safety Awareness) for the analysis of functional limitation. The data were structured using Microsoft Excel software and, for analysis, IBM SPSS Statistics for Windows was used. Logistic regression was used with the calculation of the Odds Ratio to identify the factors associated with functional limitation. A 95% confidence interval and a 5% significance level were adopted. Results: The presence of functional limitations was registered in 32% (n = 16) of the cases analyzed, especially female (56.3%), elderly (37.5%), low education (87.6%), dimorphic form (62.5%), multibacillary classification (75.0%) and degree 2 of physical disability (50.0%). Functional limitation was associated with: age group ≥ 45 years (OR 3.80; p = 0.047), multibacillary age (OR 4.28; p = 0.021) and OMP score ≥ 6 (OR 4.69; p = 0.041). 75% of individuals with limitations were aged ≥ 45 years and were multibacillary. Conclusions: The factors associated with functional limitation were age equal to or greater than 45 years, multibacillary classification and OMP score greater than or equal to six. Early diagnosis and timely treatment in the routine of health services can contribute to the prevention of physical disability and functional limitations.

Objective: To review the literature, including a clinical case discussion with suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. Methods: The study was conducted on May 28, 2020. A systematic review of the literature was conducted, with searches in PubMed, Medline, Lilacs and BVS MS using the descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, amyloid polyneuropathy. Clinical trials, cohorts, cross-sectional, clinical cases and case studies, published in Portuguese, English or Spanish between 2010 and 2020 were included. Then, a case report with an initial suspicion of pure neural leprosy was presented. Laboratory tests, electroneuromyography, ultrasound and biopsy of the sural nerve were requested. Results: 23 scientific texts were included. No publications with the two themes together were found. Diagnosis of pure neural leprosy and the possibility of using auxiliary resources were the most prominent themes in the studies. In the clinical case, the patient’s electroneuromyography showed sensitive and motor polyneuropathy of lower limbs, symmetrical, of moderate intensity, of the mixed type (axono- demyelinating), sensitive and axonal. Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves and biopsy of the sural nerve demonstrated the accumulation of amorphous eosinophilic material in the nerve path and Congo red staining showed birefringence of the deposit in applegreen under polarized light. The final diagnosis was amyloidotic neuropathy. Conclusion: Clinical diagnosis was amyloidotic neuropathy. Diagnosis of pure neural leprosy in endemic areas of Brazil is a challenge for the health system.

Background: Leprosy is an infectious disease that is associated with functional limitation. Objective: Describe the epidemiological, neurofunctional profile and the prevalence of factors associated with the occurrence of physical disabilities due to leprosy in a reference center in Northeast Brazil. Design and setting: Cross-sectional observational study carried out at the reference center Dr. Altino Lemos Santiago, in Juazeiro / Bahia. In 2018, the municipality recorded an annual average of 95 new cases of leprosy. Methods: Study including 50 leprosy patients. Variables analyzed: gender, age, history of leprosy in the family, time to diagnosis, clinical form, operational classification, degree of disability, OMP score, peripheral nerve function, muscle strength and sensitivity. Descriptive statistics and inferential statistics (chi-square test or Fisher’s exact, Poisson regression with robust estimation and PR-prevalence reason) were used. Significance of 5%. Results: it was verified an equal distribution was found between men and women, economically active age, low education, multibacillary forms in men (64.0%) and paucibacillary forms in women (60.0%). 78% of individuals had some degree of disability. 64.0% had a compromised ulnar nerve. Plantar sensitivity was decreased in 66% of patients. The predictors of disability were: age ≥45 years (PR 1.44; p=0.005), no education (PR 1.21; p=0.013) and OMP score ≥6 (PR 1.29; p

Background: cerebrovascular diseases (CVD) are the second leading cause of death in the world. Objective: to analyze the trend of mortality from CVD in Brazil (1996-2015) and its association with the human development index (HDI) and the social vulnerability index (IVS). Methods: this is an ecological study involving mortality rates standardized by CVDD. Death data were obtained from the Mortality Information System and population data from the Brazilian Institute of Geography and Statistics. For temporal analyzes, the inflection point regression model was used, with the annual percentage change (APC) and average annual percent change (AAPC), with a confidence interval of 95% and significance of 5%. The trends were classified as increasing, decreasing or stationary. The multivariate regression model was used to test the association between mortality from CVD, HDI and IVS. Results: 1,850,811 deaths due to CVD were recorded in the studied period. There was a reduction in the national mortality rate (APC:-2.4; p=0.001). Twenty federative units showed significant trends, 13 of which were decreasing, including all from the Midwest (n=4), Southeast (n=4) and South (n=3) regions. The HDI had a positive association and the IVS, a negative association with mortality (p=0.046 and p=0.026, respectively). Conclusion: the study showed an unequal epidemiological behavior of mortality among the regions, being higher in the states of the Southeast and South, but with a significant tendency to decrease, and lower in the states of the North and Northeast, but with a significant trend of growth. HDI and IVS were associated with mortality.

Background: Meningitis is a disease considered endemic in Brazil and is included in the national list of compulsory notification diseases. The presentstudy analyzed the impacts of the pandemic triggered by COVID-19 on compulsory notification of meningitis in Brazil in 2020. Methods: This is an ecological, quantitative and descriptive study. The data were collected from the DATASUS Diseases and Notification Information System (SINAN), referring to the period from 2015 to 2020, from January to August of each year. The variables analyzed were the region / unit of the notification federation and the month of notification, with the information divided into two groups: general population and children under 15 years old. The values were subjected to statisticals analysis of the P-score. Results: In Brazil 10,634 notifications of meningitis were expected in 2020. However, only 4,712 cases were reported. With the exception of Roraima, all states had a negative P- score in the two groups investigated: Rondônia had a greater discrepancy between the observed and expected values (-100%), as no notification records for the year 2020 were found; the P-score of Roraima was positive, with an increase of 22.8% in addition to the predicted notifications. Regarding the regions, the Southeast presented -56.8% of the predicted notifications, the South -55.9%, the Midwest -50.3%, the North -52.5% and the Northeast -54.2 %. Conclusion: The study showed a negative impact on meningitis notifications in Brazil, in all regions and in all states, except in Roraima.

Background: Stroke is the second leading cause of death in the world, causing thousands of hospital admissions and whose morbidity and health care costs are high. Objectives: To analyze the temporal behavior of hospitalization of elderly people due to stroke in Brazil, regions and Federation Units (UF), 2008- 2019. Design and setting: Ecological study. The space units were Brazil, its regions and Federation Units. Methods: Data were collected on the DATASUS online platform: number of admissions, number of Hospitalization Authorizations approved (AIH), total AIH value (R$), average AIH value (R$), and average value hospitalizations (R$). Was used the joinpoint regression model to calculate the Annual Percentage Change (APC) and the Average Annual Percent Change (AAPC) with 95% confidence interval and a 5% significance level. Results: Approximately 1.4 million hospitalizations were identified in Brazil, with a total cost of R$ 1.6 billion reais and an average of 1.1 thousand reais. The Southeast region stood out in the number of hospitalizations (n = 574399; 42.1%), approved AIH (n = 574625; 42.1%) and total amount (R $ 677,444,257.54; 43.4%). Throughout the time series, the number of hospitalizations increased by 52.3% and the number of approved AIH increased by 52.4%. The mean values of hospitalizations and AIH increased, respectively, 55.4% (AAPC: 3.9; CI: 3.2; 4.5) and 55.3% (AAPC: 3.9; CI: 3, 2; 4.5), while the total value of hospitalizations increased by 134.9% (AAPC 8.0; CI: 6.9; 9.1). Conclusions: There was an increase in variables related to hospitalization and stroke costs in the elderly in Brazil.

Introduction: In the last decades the number of leprosy cases has been decreasing in the world. This reduction has been questioned by researchers who believe there are more patients. Objectives: To analyze the temporal evolution of three epidemiological indicators (prevalence rate, grade II rate of physical disability and proportion of multibacillary cases) in order to find evidence of late diagnosis and hidden prevalence of leprosy in the state of Bahia, Brazil. Design and setting: This is an ecological study of time series. The unit of analysis was Bahia, Brazil. Methods: The data were obtained the DATASUS platform (http://datasus. saude.gov.br/). The inflection point regression model (joinpoint) was applied to assess the trend of the indicators from 2001 to 2015. The significance level of 5% and 95% confidence interval(95% CI). Results: There was a tendency to reduce the prevalence (AAPC -5.5%;p

The marine crab Plagusia depressa, despite its broad geographic range, is not well known. Here, we attempt to fill this gap by studying several aspects of its biology. We sampled P. depress...