Stroke / complications

IJCS

Editorial

AVC – Optimizing Pre-Hospital Care For A Time-Sensitive Disease

The care of patients with acute illnesses, in which the time to start treatment can have an important influence on the prognosis, requires a strategy based on well-defined structure and processes. Acute stroke is a disease whose prognosis is causally related to the length of care, and the possibility of implementing cerebral reperfusion therapies and neuroprotective measures. The recommendations suggest that the time should be optimized in the different phases of care, in the recognition of signs and symptoms, medical evaluation, computed tomography and thrombolysis, for patients who meet the criteria for their performance. The instruction of the population to identify the clinical manifestations of stroke, prioritizing the search for assistance, is an important step in this chain of treatment, which can modify the outcomes of this disease.

As a result, access to treatment is another major challenge. Interventions that effectively demonstrated an impact on outcomes in acute ischemic stroke, need a structure that can be supported, in large part, by telemedicine, significantly increasing patient access. National experiences have shown important results in improving the rate of pharmacological thrombolysis and thrombectomy, when designing a service network strategy with the support of neurologists, neuroradiologists and neurointerventionists.

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IJCS

Original Article

Evolution of Mortality from Diseases of the Circulatory System and of Gross Domestic Product per Capita in the Rio de Janeiro State Municipalities

Gabriel Porto Soares et al. Carlos Henrique Klein Nelson Albuquerque de Souza e Silva Glaucia Maria Moraes de Oliveira

Abstract

Background:

Diseases of the circulatory system are the leading cause of death in Brazil and the world, falling progressively during the twentieth century, preceded by an increase in Gross Domestic Product.

Objective:

To correlate balanced and adjusted mortality rates from circulatory system diseases in the municipalities of Rio de Janeiro state between 1979 and 2010 with the gross domestic product per capita (GDPpc) beginning in 1950.

Methods:

Population and death data were obtained from the Department of Information and Computer Services at the National Health System/Brazilian Ministry of Health (Departamento de Informática do Sistema Único de Saúde – Ministério da Saúde – DATASUS-MS). Mortality rates were calculated for Ischemic Heart Disease (IHD), Cerebrovascular Disease (CBVD), and Circulatory System Disease (CSD); adjusted by the direct method; and balanced for ill-defined causes. The GDPpc data were obtained from the Institute of Applied Economic Research (Instituto de Pesquisas Econômicas Aplicadas – IPEA). Mortality rates were correlated with socioeconomic indicators using Pearson’s linear correlation coefficient to determine the annual optimized lag time. Regression slope coefficients between the dependent disease and independent socioeconomic indicator were estimated.

Results:

In recent decades, there has been a reduction in mortality from CSD in all Rio de Janeiro state municipalities, mainly due to a decline in mortality from CBVD. The decline in mortality from CSD was preceded by an increase in the GDPpc, and a strong correlation was observed between this index and mortality rates.

Conclusion:

The evolution of the variation in GDPpc demonstrated a strong correlation with the reduction in CSD mortality. This relationship demonstrates the importance of improving the living conditions of the population to reduce cardiovascular mortality.