ANÁLISE TEMPORAL DE CASOS DE AVC E INFARTO NO BRASIL: TENDÊNCIAS E FATORES ASSOCIADOS ( 2018-2023)

Cerebrovascular Accident (CVA) and Acute Myocardial Infarction (AMI) are two of the leading causes of morbidity and mortality worldwide. Both result from circulatory problems, with CVA affecting the brain and AMI impacting the heart. This study aims to conduct a temporal analysis of the clinical and epidemiological landscape of hospitalizations due to Acute Myocardial Infarction and Cerebrovascular Accident in Brazil. It is a descriptive, quantitative, and retrospective study based on data obtained from the Hospital Morbidity System (SIH) at the Department of Informatics of the Unified Health System (DATASUS). The total number of confirmed hospitalizations for AMI or CVA in Brazil between 2018 and 2023 was 1,995,486. The Southeast region of the country had the highest number of cases (n=898,358). The age group with the highest frequency of AMI and CVA cases was 60 to 69 years, accounting for 27.80% (n=554,819) of the cases. Most individuals were of mixed race, representing 38.83% (n=774,936) of the cases, followed by self-declared white individuals at 36.94% (n=737,310). The majority of the sample was composed of males, representing 57.23% (n=1,142,050). Most patients were admitted on an emergency basis, totaling 93.95%. The average length of hospitalization was 7.1 days. There were 244,742 deaths during the analyzed period, with 28% of these patients being between 70 and 79 years of age. The study revealed a growing trend in the number of cases and an increase in incidence among younger individuals, although there are few studies in the field to explain this phenomenon.O Acidente Vascular Cerebral (AVC) e o Infarto Agudo do Miocárdio (IAM) são duas das principais causas de morbidade e mortalidade no mundo. Ambos resultam de problemas na circulação sanguínea, com o AVC afetando o cérebro e o IAM impactando o coração. O presente trabalho tem o objetivo de fazer uma análise temporal acerca do panorama clínico e epidemiológico das internações por Infarto Agudo do Miocárdio e Acidente Vascular Encefálico no Brasil .Trata-se de um estudo descritivo, quantitativo e retrospectivo,com base em dados obtidos através do Sistema de Morbidade Hospitalar (SIH), no Departamento de Informática do Sistema Único de Saúde (DATASUS). O total de casos confirmados de internação por IAM ou AVC, no Brasil, entre 2018 e 2023, foi de  1.995.486 . O sudeste do país foi a região que apresentou maiores números de casos (n=898.358).A faixa etária com maior frequência de casos de IAM e AVC foi a de 60 a 69 anos,  correspondendo a um percentual de 27,80% (n=554.819) dos casos. Os indivíduos, em sua maioria, apresentavam a cor/ raça parda correspondendo a 38,83% (n=774.936) dos casos, seguido dos indivíduos autodeclarados brancos com percentual de 36,94% (n=737.310).  A amostra , em sua maioria,foi composta por indivíduos do sexo masculino 57,23% (n=1.142.050). A maioria dos pacientes deu entrada no hospital em caráter de urgência correspondendo a um total de 93,95%. A média de internação dos pacientes foi de 7,1 dias. Houveram 244.742 óbitos durante o período analisado, dos quais 28% eram pacientes entre 70 a 79 anos de idade. No estudo, ficou evidente o padrão de crescimento do número de casos e um aumento da incidência em pessoas mais jovens, embora não haja muitos estudos na área que possam explicar esse fenômeno

COVID-19 in Brazilian children and adolescents: findings from 21 hospitals / COVID-19 em crianças e adolescentes brasileiros: registros de 21 hospitais

Introdução: Crianças e adolescentes com Covid-19 apresentam menor mortalidade e sintomas menos intensos quando comparados aos adultos. Os estudos no Brasil baseiam-se apenas no sistema de notificação compulsória. Objetivo: Analisar as características clínicas, laboratoriais, radiológicas e desfechos de pacientes hospitalizados com menos de 20 anos de idade com Covid-19. Métodos: Série de casos de pacientes internados com Covid-19, confirmado, com idade inferior a 20 anos, obtida em estudo de coorte em 21 hospitais de cinco estados brasileiros. Resultados: Dos 36 pacientes, 20 (55,5%) eram adolescentes, 20 (55,5%) eram do sexo masculino, 18 (50,0%) apresentavam comorbidades, 2 estavam grávidas; e em 7 (19,4%) os sintomas iniciais ocorreram durante a internação por outras causas, dos quais 3 foram possivelmente infectados no hospital. Febre (61,1%), dispneia (33,3%) e sintomas neurológicos (33,0%) foram as queixas mais comuns. A proteína C reativa estava acima de 50mg / L em 16,7% e o dímero-D estava acima do limite de referência em 22,2%. Radiografias de tórax foram realizadas em 20 (55,5%) pacientes, 9 apresentavam anormalidades; e tomografias computadorizadas de tórax em 5. O tempo de internação variou de 1-40 dias (mediana 5 [intervalo interquartil 3-10]), 16 (44,4%) necessitaram de cuidados intensivos, 6 (16,7%) necessitaram de ventilação mecânica e um paciente (2,8%) faleceu. Conclusão: Em uma amostra de pacientes menores de 20 anos, procedentes de hospitais de 5 estados do Brasil, as comorbidades foram frequentes e os sintomas mais comuns foram febre, dispneia e sintomas neurológicos. Quarenta e quatro por cento dos pacientes necessitaram de cuidados intensivos, mostrando que na amostra avaliada a doença não era tão leve quanto o esperado, e um paciente morreu. 

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file