Perfil epidemiológico das internações por condições sensíveis à atenção primária de saúde no estado de Roraima

Introduction: The Primary Care Sensitive Conditions (CSAP) comprise the health problems that are treated in the first level of health care; if this care is neglected, an evolution of the illness may happen, requiring hospitalization. Objective: Understand the characteristics of hospitalizations due to primary care sensitive conditions that occurred in the Hospitals of Roraima during the period from 2011 to 2015. Methods: This is a population-based ecological study using DATASUS secondary data. Results: During the period under study, 155,063 hospitalizations were detected in HGR, of which 22.79% (35,344) were consequences from Primary Care Sensitive Conditions and 82.19% of the hospitalizations were from patients living in Boa Vista; the bacterial pneumonia was the main cause of hospitalization, followed by skin and subcutaneous tissue infections. Conclusions: : In this study, it was possible to quantify the number of hospitalizations that occurred in the state of Roraima from 2011 to 2015 and to outline a profile of the hospitalizations by CSAP, identifying the main causes that require interventions through programs in primary care.Introdução: As Condições Sensíveis à Atenção Primária (CSAP) compreendem os agravos em saúde que são atendidos no primeiro nível de atenção à saúde, caso esse atendimento seja negligenciado pode haver evolução deste agravo sendo necessária internação hospitalar. Objetivo: Conhecer as características das internações por condições sensíveis à atenção primária que ocorreram nas Instituições Hospitalares do estado de Roraima no período de 2011 à 2015. Métodos: Trata-se de um estudo ecológico de base populacional que utiliza dados secundários do DATASUS. Resultados: No período estudado, evidenciou-se a ocorrência de 155.063 internações no HGR, sendo que 22,79% (35.344) destas foram internações por Condições Sensíveis a Atenção Primária e 82,19% referentes a e pacientes residentes em Boa Vista, visto que as pneumonias bacterianas foram as principais causas de internação, seguido por infecção da pele e tecido subcutâneo. Conclusões: Neste estudo foi possível quantificar as internações ocorridas no estado de Roraima de 2011 à 2015 e traçar um perfil das internações pelas CSAP, identificando as principais causas de internação que necessitam de intervenção por meio de programas dirigidos na atenção primária

Fatal Rattlesnake Envenomation in Northernmost Brazilian Amazon: A Case Report and Literature Overview

Snakebite envenomations are classified as Category A Neglected Tropical Diseases by the World Health Organization. In Brazil, 405 snake species are distributed among 11 families, with the genera Bothrops and Crotalus being the most studied and main responsible for severe and lethal envenomations. In the country, Crotalus genus (i.e., rattlesnakes) is represented by Crotalus durissus species, showing seven different subspecies distributed along the country, including Crotalus durissus ruruima, which inhabits Roraima, the Brazilian nothermost state from Amazon forest. Here, we report a fatal case of a severe envenomation following a rattlesnake bite. The patient presented classic crotalic neurological signs and symptoms such as ptosis, drooling of saliva, sluggishness, macroscopic hematuria, and oliguria, which evolved to acute kidney failure (AKF) and hemodynamic instability. Although the patient was treated with the specific antivenom therapy, the severe envenomation resulted in three cardiac arrests and death of the victim in less than 38 h. This study discusses the causes of the patient death, the features of rattlesnake venom-induced AKF, and shows evidences that the Brazilian crotalic antivenom should be improved to treat rattlesnake envenomations caused by C. d. ruruima venom in Roraima state

Medical Management after Lancehead Snakebite in North Amazon: A Case Report of Long-Term Disability

Snakebites are a major public health problem in indigenous communities in Brazil, leading to acute local and systemic damage with resulting deficiencies. Long-term musculoskeletal disabilities related to snakebites have been a neglected area of research. Bothrops (lancehead) snakes are responsible for most of the permanent sequelae related to snakebites in Latin America. Here, we present a case report of a 32-year-old male indigenous patient who was envenomed by a Bothrops species. The patient was clinically followed for a period of approximately 2 years and 6 months, during which time he experienced a loss of musculoskeletal tissue and required several medical procedures such as debridement, tissue reconstruction, and physical therapy, which resulted in a recovery of mobility, though with a permanent sequelae in gait. This case report shows how snakebites have a significant impact on health systems, as victims require physiotherapy, plastic surgery, and orthopedics services, as well as social support for reintegration into their local communities