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Introduction: The novel Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and represents the agent responsible for a respiratory and metabolic disease with a high fatality rate, remaining a public health problem to this day. There has been an exacerbation of social inequalities experienced in Brazil and worldwide. Notably, the absence of a consolidated and universal healthcare system has contributed to the increased inequalities and survival opportunities for those affected by SARS-CoV-2 infection and manifestation of COVID-19. The southern region has become the second region with the highest number of cases in Brazil. Objective: To avaluate the epidemiological outcomes of incidence, lethality, and mortality among the states of Rio Grande do Sul and Paraná in the southern region of Brazil. Methods: An ecological time-series study was conducted using official secondary data on COVID-19 cases and deaths publicly disclosed by the health departments of the states of Rio Grande do Sul and Paraná. Time series were constructed applying the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software. Results: It was observed that for the state of Rio Grande do Sul, the trends regarding incidence were increasing in 2020 and decreasing in 2021 (p<0.05). Regarding mortality, it increased in 2020 and decreased in 2021 and 2022 (p<0.05). When assessing lethality, a decreasing trend was observed for the entire period (p<0.05). In relation to Paraná, incidence increased in 2020 and over the entire period, while it decreased in 2021 and 2022 (p<0.05). Mortality was stationary in 2020 and decreased in 2021 and 2022 (p<0.05). Conclusion: The COVID-19 pandemic is a serious public health problem in the states of Paraná and Rio Grande do Sul. Paraná presented a more severe epidemiological outcome compared to Rio Grande do Sul. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 unfolded differently in Pará and Rio Grande do Sul, Brazil, owing to distinct socioeconomic contexts. From 2020 to 2022, both states implemented diverse measures against the virus SARS-CoV-2, including vaccination and variant monitoring, tailored to their specific challenges. Understanding regional impacts on COVID-19 indicators is crucial for designing effective control strategies. Objective: to analyze the incidence, mortality, and lethality of COVID-19 in Pará and Rio Grande do Sul and the trends of these indicators from 2020 to 2022. Methods: ecological study with time series from public and official data available in the Health Secretariat of Pará and Rio Grande do Sul, including all cases and deaths by COVID-19 from February 2020 to December 2022. Lethality, mortality, and incidence rates were calculated. Prais-Winsten regression analysis was used, and trends were classified as stationary, increasing, or decreasing. Significant differences were considered when the p-value is <0.05. Results: when examining the lethality rates between the states of Para and Rio Grande do Sul, an observable trend emerged during the analyzed period. It became evident that the total lethality rate consistently remained higher in Para. Noteworthy peaks in lethality were mainly observed during the months of April 2020, May 2020, and March 2021. The incidence rates showed increasing trends during 2020, both in Pará with a daily percentage change (DPC) of 1.69% (p <0.05) and in Rio Grande do Sul with a DPC of 1.70% (p<0.05). In 2021, the incidence was decreasing (p <0.05) in both states, with a DPC of 0.60% in Pará and 0.64% in Rio Grande do Sul and continued this trend in Pará in 2022 (DPC of -0.50% p <0.05), becoming stationary in Rio Grande do Sul, with a non-significant p-value (p> 0.05). Conclusion: the positive impact of the vaccination program is reflected in the evolution of the pandemic. During the study period Rio Grande do Sul and Para exhibited a stationary incidence trend, emphasizing the need for continued monitoring of cases and morbidity across various age and demographic groups. [ABSTRACT FROM AUTHOR]

Introduction: the progression of SARS-CoV-2 highlighted the Americas region for the number of COVID-19 cases and deaths. In Brazil, the Southeast region was one of the most affected, especially the state of Rio de Janeiro, due to its cosmopolitan characteristics. Objective: to analyze temporal variations in the incidence, mortality and lethality of COVID-19 in the state of Rio de Janeiro from January 2020 to December 2022. Methods: ecological time-series study with publicly available data on COVID-19 cases and deaths. Crude incidence, mortality, and fatality rates, and estimates of percent daily change (DPC) were analyzed using Prais-Winsten linear regression. With calculation of crude rates were performed using Microsoft Excel 2019, and DPC estimates were performed using STATA MP 17.0 software. Results: 2.5 million cases and 76 thousand COVID-19 deaths were confirmed in the state of Rio de Janeiro from 2020 to 2022, with lethality declining from 4.89% to 0.60%. The highest lethality occurred in May 2020 (11.59%), October 2021 (9.13%) and March 2022 (6.78%), showing a stationary trend. In 2020, incidence and mortality rates peaked in December (797.76 per 100,000 inhabitants) and May (43.96 per 100,000 inhabitants), respectively, followed by subsequent declines. Incidence trend was increasing in 2020 and stationary in 2022, while mortality decreased in 2021 and 2022 after stability in 2020. Conclusion: The incidence of COVID-19 peaked in 2020 and subsequently declined, suggesting partial transmission control. Mortality stabilized after 2020, indicating evolution in health care. Lethality showed a stationary trend, indicating an improvement in hospital capacity. The divergent behavior of the epidemiological indicators reflected the complex dynamics of the pandemic in the analyzed state. There were 790 thousand deaths from COVID-19 in the State of Rio de Janeiro in the period from 2020 to 2022. [ABSTRACT FROM AUTHOR]

Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The World Health Organization is the global coordinating agency for the response to the COVID-19 pandemic. In March 2023, the WHO announced the end of the COVID-19 emergency phase. The end of the Public Health Emergency of International Concern does not mean that COVID-19 has ceased to be a health threat. The worldwide spread of the disease continues to be characterized as a pandemic. The significance of this decision is aimed at public health systems everywhere for countries to transition from emergency mode to management of COVID-19 along with other infectious diseases. The COVID-19 pandemic is not over. The population got tired of the virus, however, the virus did not get tired of the human population. Non-pharmacological preventive measures, vaccination and health education continue to be the arsenal we must control this disease today. [ABSTRACT FROM AUTHOR]

Introdução/Objetivo: A presença de RA traz como consequências o aumento da morbi-mortalidade, da permanência hospitalar, utilização de drogas alternativas e encarecimento da assistência. Trata-se de um problema de saúde pública exacerbado no período da pandemia de COVID-19. Segundo o “Centers for Disease Control and Prevention – CDC-USA, mais de 2,8 milhões de infecções por RA ocorrem nos EUA e mais de 35 mil pessoas morrem/ano como resultado disso. Na União Europeia, a RA é responsável por cerca de 33 mil mortes/ano e estima-se que custe 1,5 bilhão de euros anuais em gastos com saúde e em perdas de produtividade. Avaliamos a correlação entre óbitos e RA em pacientes com IRAS do HMP, no período de 2020 a 2022. Métodos: Estudo observacional da taxa de letalidade em pacientes com IRAS (critério ANVISA/COVISA) causadas por RA em pacientes internados no HMP no período de 2020 a 2022, através da análise retrospectiva das informações em banco de dados do Serviço de Controle de IRAS. Considerados como germes com RA os gram-negativos resistentes a carbapenêmicos e/ou cefalosporinas, gram-positivos resistentes à oxacilina e enterococos resistente a vancomicina. Foram analisadas 1.026 IRAS sendo considerados elegíveis 414 pacientes com IRAS, com desfecho conhecido (alta ou óbito) e presença de germe isolado. Também foram excluídos os pacientes transferidos para outras instituições. Resultados: A letalidade para IRAS por RA observada nos anos de 2020, 2021 e 2022 foi de 92%, 78%, 73% respectivamente. Para os pacientes com IRAS e sem RA foi de 42,9%, 67,7%, 72,9% respectivamente para os anos 2020, 2021 e 2022. A análise global do período para os 414 pacientes demonstrou letalidade de 77% para pacientes com RA e 68% para pacientes sem RA. Conclusão: Em 2020/2021 o HMP prestou atendimento exclusivo a pacientes com COVID-19 e a partir de 2022 assumiu caráter de hospital geral. Nesta análise pudemos observar alta letalidade nos pacientes com IRAS e RA especialmente em 2020 e 2021 período em que a COVID-19 esteve presente entre as comorbidades. No período de 2020-2022, dos 414 pacientes estudados, 207 (50%) estavam com RA e foram a óbito, 101 (25%) sem RA foram a óbito. Receberam alta 59 (14%) com RA e 47 (11,5%) sem RA. Os nossos dados demonstram o aumento da gravidade das IRAS na presença de comorbidades como a COVID-19 e na presença de RA com aumento da letalidade.

Justificativa e objetivo: a síndrome da imunodeficiência adquirida (aids) apresenta elevadas taxas de detecção e óbito no estado do Rio Grande do Sul. A fim de compreender melhor tais óbitos, em dezembro de 2017, a Secretaria Municipal de Saúde de Uruguaiana implementou o Comitê de Mortalidade por aids (CMaids). O objetivo deste estudo é analisar o impacto da implantação do CMaids de Uruguaiana por meio de indicadores de saúde municipais. Métodos: estudo ecológico de série temporal, utilizando dados secundários das plataformas oficiais do Ministério da Saúde entre o período de 2008 a 2020. Resultados: observou-se redução dos indicadores número de óbitos (de 28 em 2008 para 9 em 2020), taxa de mortalidade (de 22,0 em 2008 para 7,1 óbitos/100.000 habitantes em 2020) e taxa de letalidade (de 46,74 em 2008 para 9,61 óbitos/1.000 habitantes em 2020). Ainda, verificaram-se linhas de tendência entre 2017-2020 por meio do modelo de regressão logarítmica com pontos de junção. Averiguou-se relevante mudança percentual anual nos indicadores de mortalidade e letalidade, com redução de 59,1% e 73,4%, respectivamente, em 2020, ao comparar-se o valor observado e o esperado. Conclusão: os achados permitem conjecturar que o CMaids contribuiu para melhorias dos indicadores de saúde, evidenciando essa como uma estratégia relevante para o enfrentamento do HIV/aids em nível local.

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Justificativa e objetivos: a leishmaniose visceral humana (LVH) constitui-se em persistente problema de saúde pública, configurando-se um desafio à redução de sua letalidade. Para avaliação dos fatores associados à letalidade, este estudo tem ênfase no tempo decorrido da suspeição ao tratamento de LVH, nos anos de 2015 a 2019, no município de Araguaína-TO, área de transmissão intensa. Métodos: estudo epidemiológico de série de casos com acompanhamento longitudinal, com informações extraídas das fichas de notificação e investigação de LVH. Utilizou-se o risco relativo (RR) como medida de força de associação para o óbito, sendo calculado com intervalos de confiança (IC 95%) estimados pelo Teste de Wald. Os intervalos de tempo foram representados em dias por box plot em medianas (Md). Resultados: dos 191 casos de LVH, 179 (93,72%) obtiveram cura e 12 (6,28%) apresentaram desfecho fatal. Não houve associação de risco de morte por sexo, escolaridade, raça ou cor, sendo significativa apenas por idade nas faixas etárias de adultos jovens (RR= 16,09) e idosos (RR=7,08). O tempo da suspeição ao tratamento em crianças foi mais curto (0-35 dias, Md= 12) que o de pacientes mais velhos (4-44 dias, Md=18) e naqueles que evoluíram ao óbito (7-65 dias, Md=20), realçando maior inoportunidade de cura nesses dois últimos grupos. Conclusão: o diagnóstico tardio foi um indicador determinante para piores desfechos, e cinco dias fizeram a diferença entre o grupo com desfecho para cura e o grupo dos que vieram a óbito, destacando a necessidade de encurtamento da espera para tratamento.

Introduction: the initial spread of the pandemic in Brazil was mainly affected by patterns of socioeconomic vulnerability. It should be noted that the Central-West region of Brazil is one of the regions with the lowest number of cases, but the states of this region together have the highest mortality rate of COVID-19 in the country. Goiás was the most affected state of this region, with the highest number of deaths in the area. Objective: to assess the incidence of mortality and lethality caused by COVID-19 from March 2020 to June 2021 in the State of Goiás, Brazil. Methods: an ecological study, using a series of time series of public and official data of the Department of Health of the State of Goiás, Brazil. Information was collected on cases and deaths from COVID-19 from March 2020 to June 2021. Mortality, case fatality, and incidence rates were calculated. The Prais- Wisten regression model was used to build time series. The daily percent change (DPC) and the effective reproductive number (Rt) were estimated. Results: Goiás had a predominance of a greater viral spread during the first and the beginning of the second wave, with Rt higher than 1. The second wave from December 2020 to June 2021 was more lethal and had higher mortality rates than the first wave. It was observed, higher scores of case fatality and mortality belonged to males and the elderly. Conclusion: an analysis of mortality and case fatality rates helps understand the COVID-19 pandemic behavior in Goiás. It is essential to monitor epidemiological indicators and strengthen intervention strategies to contain the pandemic in this state. [ABSTRACT FROM AUTHOR]

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, time-series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this timeseries analysis. Remarkably, the Second Wave had the highest lethality rates (3.02% - April 2021), mortality (39.81 deaths per 100,000 inhabitants -- March 2021), and incidence (1,938.88 cases per 100,000 inhabitants -- March 2021). At the end of the period, mortality, incidence, and lethality showed flat trends, suggesting a positive outcome of the vaccination program. Conclusion: The prevention, surveillance, and control actions of COVID-19 cases in Tocantins State have been directed to mitigate the deleterious effects of the pandemic. Nevertheless, efforts are still needed to decrease lethality, mortality, and incidence trends, and ultimately to achieve control of the COVID-19 pandemic in the region. [ABSTRACT FROM AUTHOR]

Introduction: By late 2019, China notified a new disease rising, and with the agent's identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil. Objective: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021. Methods: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first "wave" (March to November 2020) and a second "wave" (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat. Results: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p<0,001). The mortality and incidence showed an increasing trend (DPC=1,13, p<0,001; DPC=1,58, p<0,001, respectively). Conclusion: The level and variability of transmission during this first year of pandemic suggest that the disease in the State of Paraná was never under control. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus 2019 Disease (COVID-19) was quickly declared a pandemic, and Brazil is facing the most significant health and hospital crisis in its history. From March to June 2021 represented 50.8% of all deaths in the State of Espirito Santo. Objective: To analyze the lethality and mortality by COVID-19 in the State of Espirito Santo from March 2020 to June 2021. Methods: An ecological study was carried out, using a time series of public and official data available on the Health Department of the State of Espirito Santo, Brazil. Were considered information about cases and deaths (from March 2020 to June 2021) of COVID-19. Percentage case-fatality and mortality and incidence rates per 100,000 population were calculated. Timeseries analyses were performed using the Prais-Winsten regression model, estimating the Daily Percent Change (DPC), and the trends were classified as flat, increasing, or decreasing. Significant differences were considered when p<0.05. Results: 524,496 confirmed cases of COVID-19 as of June 30, 2021, and 11,516 progressed to death. The presence of cardiovascular diseases represents more than half of confirmed comorbidities (54.37%) in patients with COVID-19, followed by diabetes (19.95%) and obesity (9.34%). Men had higher mortality and lethality, especially in older age groups, but the incidence was higher among women. A characteristic profile of two waves was observed; the first wave was extended from March to October 2020 and the second complete wave from November 2020 to June 2021. During the second wave, high peaks of incidence, lethality, and mortality were recorded. At the end of the second wave, the incidence rate remained with increasing trends (p < 0.05), with a DPC of 2.06%. Conclusion: The peak concentration of cases, deaths, and indicators of lethality, mortality evidenced even after one year of pandemic, characterizes the severity of the COVID-19 pandemic, still in entire evolution in the State Espirito Santo and Brazil. [ABSTRACT FROM AUTHOR]

Introduction: the new coronavirus (COVID-19) disease has been causing economic and health system impacts worldwide, triggering humanitarian crises in vulnerable regions, marked by high mortality rates of the disease. Brazil has been suffering an increase in the number of cases, characteristic of the formation of a second wave, with great epidemiological differences observed in the most diverse regions of the country. Many studies illustrate the behaviour of COVID-19 in the state of São Paulo, but there are gaps in the scientific literature on the epidemiology of COVID-19 in municipalities of the São Paulo metropolitan region that constitute an important industrial pole in Latin America, such as the region of Grande ABC. Objective: to evaluate mortality and lethality trends of COVID-19 during the period March 2020 to July 2021, in municipalities on region of Grande ABC, metropolitan region of São Paulo, Brazil, divided into two periods (March to November 2020 and December to July 2021). Methods: we conducted an ecological time series study with population data from the Brazilian Ministry of Health. We collected the number of cases and deaths confirmed for COVID-19 in the municipalities that make up the region of Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo, and São Caetano do Sul) from March 2020 to July 2021. Prais-Winsten linear regression was performed, and the percentage of daily change was calculated. Differences were considered significant when p<0.05. Results: in region of Grande ABC, in the period analysed, 217,264 cases and 10,004 deaths of COVID-19 were recorded. Although the mortality rate remained stationary during the first wave (March to November 2020) and the second wave (December 2020 to July 2021); lethality transitioned from decreasing during the first wave to increasing during the second wave, with rates varying according to municipality. Conclusion: trend analyses in incidence, mortality, and lethality rates assist in understanding the behaviour of the COVID-19 Pandemic in the region known as Grande ABC. Efforts must be maintained throughout the region to control the Pandemic. [ABSTRACT FROM AUTHOR]

Introduction: the growth of coronavirus indices in the North region highlights the region's historical social inequalities and the problems in accessing citizenship. Objective: to analyze the mortality and lethality of COVID-19 in the state of Pará, Brazil. Methods: this is an ecological study with a time series design of secondary data. All registered cases and deaths reported by COVID-19 in the period from March 2020 to June 2021, in the state of Pará, Brazil, were considered. The incidence and mortality and lethality rates were used. The daily percentage variation and their respective 95% confidence intervals were estimated. Results: the total number of confirmed cases and deaths from COVID-19 in the state of Pará was 552,937 and 15,469, respectively, from March 2020 to June 2021. Incidence and mortality rates from March 2020 to June 2021 were, respectively, 6,407.9 and 179.3 per 100,000 inhabitants and the lethality was 43.3. Regarding the analysis of the daily trend of rates in the period from March 2020 to June 2021, both mortality and incidence increased. Conclusion: it was found that the behavior of the trend of rates in the first wave was increasing in the incidence of confirmed cases and the lethality decreasing, and in the second wave, the mortality and lethality rates were increasing. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 impacted health systems worldwide; the virus quickly spread in Brazil, reaching the 27 Federative units in Brazil peculiarly. The northern region of Brazil recorded the lowest number of cases and accumulated deaths from the disease. However, it is a region of sizeable territorial extension and low demographic density, marked by socioeconomic inequalities and vulnerable groups, such as indigenous tribes, riverine peoples, and quilombolas. Sociodemographic factors may contribute to the dissemination of the coronavirus in the region; thus, studies are needed to analyze the epidemiological indicators related to the pandemic. Objective: to evaluate incidence, mortality, and case fatality of COVID-19 trends in the state of Amapá, Brazil, from March 2020 to April 2021. Methods: an ecological time-series study was conducted with publicly accessible data from the Health Department of the State of Amapá. Incidence and mortality rates per 100,000 inhabitants and percentage case fatality were calculated. Crude rates were calculated by municipalities, age, and sex, per month. The Prais-Winsten regression test was performed, and the trends of monthly rates were classified as increasing, decreasing, or flat. Results: during the study period, there were 99.936 cases and 1,468 deaths accumulated by COVID-19 in the State of Amapá, Brazil. Macapá and Santana's cities, which have the highest demographic density and Human Development Index (HDI), had the highest number of cases and deaths. The most vulnerable population was elderly males aged 70 years or over; these individuals had the highest cumulative incidence, case fatality, and mortality rates. The second wave of the disease (October 2020 to April 2021) illustrated a more aggravating scenario, with increasing incidence and mortality rates. Conclusion: the COVID-19 pandemic in the state of Amapá, Brazil, is in increasing evolution, which illustrates that non-pharmacological prevention measures and acceleration of vaccination must be strengthened to avoid the development of future waves of the disease. [ABSTRACT FROM AUTHOR]

O primeiro caso confirmado de COVID-19 foi notificado ao Ministério da Saúde (MS) do Brasil em 26 de fevereiro de 2020. Até o final da Semana Epidemiológica (SE) 46 de 2021, no dia 20 de novembro de 2021, foram confirmados 257.168.692 casos de covid-19 no mundo. Os Estados Unidos foram o país com o maior número de casos acumulados (47.701.872), seguido pela Índia (34.510.413), Brasil (22.012.150), Reino Unido (9.857.658) e Rússia (9.135.149). Em relação aos óbitos, foram confirmados 5.146.467 no mundo até o dia 20 de novembro de 2021. Os Estados Unidos foram o país com maior número acumulado de óbitos (771.013), seguido do Brasil (612.587), Índia (465.662), México (292.145) e Rússia (257.891) [ABSTRACT FROM AUTHOR]

Introduction: In 2019, the proliferation of a virus identified as SARS-CoV-2 emerged in the city of Wuhan, a district in China, quickly spread throughout the world, gaining pandemic status and less than 1 year, its repercussions and magnitude caused scientists, governments and society to adopt severe measures to combat this disease. Objective: To analyze mortality, incidence and mortality from COVID-19 in the municipalities of Botucatu and Serrana, São Paulo, Brazil. Methods: This is an ecological study with a time series design with secondary data. All registered cases and deaths registered by COVID-19 from April 2020 to August 2021 in the municipalities of Botucatu and Serrana, São Paulo, Brazil were considered. The incidence, mortality and lethality rate were used. The monthly and/or weekly percentage variation and their respective 95% confidence intervals were estimated. Results: It identified that 12.88% of the residents of the city of Botucatu were infected with COVID-19 and 8.61% of the population of the municipality of Serrana was infected. There was a stationary trend of mortality and incidence in the period between April 2020 and May 2021 and decreasing in both sexes in the mortality rate in the municipality of Serrana, in the city of Botucatu there was a trend of increasing mortality and incidence in the same period observed. Conclusion: The mass vaccination strategy of citizens in the cities of Botucatu and Serrana present robust data to consider that immunization has a decreasing effect on the number of cases and deaths from COVID-19, which effectively contributes to fighting the pandemic and reduces the contamination and progression of the disease to more severe cases. [ABSTRACT FROM AUTHOR]

Introduction: continual mutations of the sars-cov-2 virus, with the possibility of reinfection or reactivation of the virus, can lead to a further spread of the virus and consequently new infection periods. The state of pernambuco, brazil, has faced many adversities amidst the pandemic, requiring studies and new spatiotemporal techniques to understand the pandemic development and planning actions to reverse the current situation. Objective: the aim was to evaluate the mortality and lethality trends of covid-19 from april 2020 to june 2021 in the state of pernambuco, brazil, with the division into two periods according to the waves of infection to date (1st period and 2nd period). Methods: an ecological time-series study was carried out with population data from the pernambuco state health department. We collected the number of confirmed cases and deaths for covid-19. The trends were analyzed according to the praiswinsten regression model in two moments from march 2020 to september 2020 and the second from october 2021 to june 2022. Differences were considered significant when p<0.05. Results: the state of pernambuco had 581,594 confirmed cases of covid-19, where 51,370 were severe cases, and 530,224 were mild cases, in addition to 18,444 deaths. Given the trends analyzed, mortality was increasing in the second period (april/2020 to june/2021), while lethality decreased in the first period and was stationary in the second period. Conclusion: this study found an increasing trend in mortality of covid-19 in the state of pernambuco, brazil in the second period, highlighting an urgent need to develop surveillance measures as well as public policies for vulnerable populations, in addition to continuing preventive measures. [ABSTRACT FROM AUTHOR]

Resumo O artigo discute os processos e taxonomias utilizadas para classificar os episódios de homicídios praticados por policiais no Brasil, utilizando como estudo de caso o estado de São Paulo. Trata-se de um esforço de diálogo entre os campos da sociologia da segurança pública e o da sociologia da quantificação aliado ao estudo empírico da produção e uso de estatísticas criminais por parte das instituições que compõem o sistema de justiça criminal e segurança pública do Brasil. O objetivo, aqui, é relatar como a disputa em torno das mortes decorrentes de intervenções policiais está inserida em uma disputa maior sobre o sentido das políticas de segurança pública, e que as nomenclaturas adotadas consistem em táticas que buscam garantir a legitimidade do uso da força letal pelas polícias. A criação de múltiplas categorias para mensurar o resultado morte em decorrência da atividade policial e sua contabilização apartada dos homicídios dolosos constituem estratégia que turva a compreensão completa do significado dessas ocorrências e revela o quanto a opacidade ainda está presente, no país, na forma de governar e responder às demandas por mais eficiência no controle do crime e na manutenção da ordem pública.

Objective: To analyze sex differences in Covid-19 lethality among elderly people in Pará in 2020. Methods: Data were obtained directly from SESPA electronic epidemiological bulletins between March 18 and December 31, 2020. descriptive, comparative and logistic regression analyses, considering a significance level set at p=0.05. Results: Most of the registered cases were aged between 60 and 69 years. Mortality among men is 1.6 times higher than among women, and this difference increases to 1.8 among the younger elderly. Regarding geography, of the total of 144 municipalities, only seven did not register deaths by Covid-19 among men. In addition, some associates dissipate above the state average, such as Colares, Capanema, Novo Repartimento, São Francisco do Pará and Almeirim. In São João do Araguaia, lethality among men is five times higher than in the state of Pará. Conclusion: This significant effect of differences in lethality in elderly men is relevant, and added the data in relation to socioeconomic conditions and of medical history can help in the elaboration of more specific and appropriate answers for this portion of the population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 continues to have a major impact on health and social systems around the world. The COVID-19 and influenza manifest themselves in a similar way, causing respiratory diseases that can present asymptomatically, as well as from the cold to severe respiratory problems until death. The form of transmission is similar, through contact with droplets or particles of saliva and secretions, which implies preventive actions that involve the same hygiene measures, use of masks and the need to cough using the elbow or disposable tissues. This characterizes a syndemic. It becomes necessary to monitor these diseases so that there are parameters for better decisionmaking on the appropriate clinical management of these respective diseases. [ABSTRACT FROM AUTHOR]

Resumo A polícia constitui o principal mecanismo encontrado pelo Estado moderno para garantir a manutenção da lei e da ordem, tendo como prerrogativa a regulação das relações sociais mediante força física como ato legítimo e constitutivo de sua função. Desse modo, ao mesmo tempo que representa a autoridade para intervir quando necessário for, pode constituir um poderoso instrumento de violação de direitos dos cidadãos quando faz uso abusivo da força, em especial a letal. Este artigo apresenta uma análise descritiva das ocorrências de letalidade policial no Estado de São Paulo tendo por base a análise dos boletins de ocorrência dos casos de morte decorrente de intervenção policial. Os resultados indicam que, mesmo diante da redução expressiva dos homicídios dolosos, a letalidade da polícia cresceu substancialmente ao longo dos anos 2000, vitimando desproporcionalmente adolescentes e jovens, pretos e pardos. Concluímos que as polícias paulistas têm se excedido no uso da força letal e sugerimos o fortalecimento do controle interno das corporações para o enfrentamento do problema.]

Introduction: coronavirus 2019 Disease (COVID-19) was quickly declared a pandemic, and Brazil is facing the most significant health and hospital crisis in its history. From March to June 2021 represented 50.8% of all deaths in the State of Espirito Santo. Objective: to analyze the lethality and mortality by COVID-19 in the State of Espirito Santo from March 2020 to June 2021. Methods: an ecological study was carried out, using a time series of public and official data available on the Health Department of the State of Espirito Santo, Brazil. Were considered information about cases and deaths (from March 2020 to June 2021) of COVID-19. Percentage case-fatality and mortality and incidence rates per 100,000 population were calculated. Time-series analyses were performed using the Prais-Winsten regression model, estimating the Daily Percent Change (DPC), and the trends were classified as flat, increasing, or decreasing. Significant differences were considered when p<0.05. Results: 524,496 confirmed cases of COVID-19 as of June 30, 2021, and 11,516 progressed to death. The presence of cardiovascular diseases represents more than half of confirmed comorbidities (54.37%) in patients with COVID-19, followed by diabetes (19.95%) and obesity (9.34%). Men had higher mortality and lethality, especially in older age groups, but the incidence was higher among women. A characteristic profile of two waves was observed; the first wave was extended from March to October 2020 and the second complete wave from November 2020 to June 2021. During the second wave, high peaks of incidence, lethality, and mortality were recorded. At the end of the second wave, the incidence rate remained with increasing trends (p < 0.05), with a DPC of 2.06%. Conclusion: the peak concentration of cases, deaths, and indicators of lethality, mortality evidenced even after one year of pandemic, characterizes the severity of the COVID-19 pandemic, still in entire evolution in the State Espirito Santo and Brazil. [ABSTRACT FROM AUTHOR]

Introduction: By late 2019, China notified a new disease rising, and with the agent's identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil. Objective: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021. Methods: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first "wave" (March to November 2020) and a second "wave" (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat. Results: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p<0,001). The mortality and incidence showed an increasing trend (DPC=1,13, p<0,001; DPC=1,58, p<0,001, respectively). Conclusion: The level and variability of transmission during this first year of pandemic suggest that the disease in the State of Paraná was never under control. [ABSTRACT FROM AUTHOR]

Introduction: the initial spread of the pandemic in Brazil was mainly affected by patterns of socioeconomic vulnerability. It should be noted that the Central-West region of Brazil is one of the regions with the lowest number of cases, but the states of this region together have the highest mortality rate of COVID-19 in the country. Goiás was the most affected state of this region, with the highest number of deaths in the area. Objective: to assess the incidence of mortality and lethality caused by COVID-19 from March 2020 to June 2021 in the State of Goiás, Brazil. Methods: an ecological study, using a series of time series of public and official data of the Department of Health of the State of Goiás, Brazil. Information was collected on cases and deaths from COVID-19 from March 2020 to June 2021. Mortality, case fatality, and incidence rates were calculated. The Prais-Wisten regression model was used to build time series. The daily percent change (DPC) and the effective reproductive number (Rt) were estimated. Results: Goiás had a predominance of a greater viral spread during the first and the beginning of the second wave, with Rt higher than 1. The second wave from December 2020 to June 2021 was more lethal and had higher mortality rates than the first wave. It was observed, higher scores of case fatality and mortality belonged to males and the elderly. Conclusion: an analysis of mortality and case fatality rates helps understand the COVID-19 pandemic behavior in Goiás. It is essential to monitor epidemiological indicators and strengthen intervention strategies to contain the pandemic in this state. [ABSTRACT FROM AUTHOR]

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, timeseries analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this timeseries analysis. Remarkably, the Second Wave had the highest lethality rates (3.02% - April 2021), mortality (39.81 deaths per 100,000 inhabitants - March 2021), and incidence (1,938.88 cases per 100,000 inhabitants - March 2021). At the end of the period, mortality, incidence, and lethality showed flat trends, suggesting a positive outcome of the vaccination program. Conclusion: The prevention, surveillance, and control actions of COVID-19 cases in Tocantins State have been directed to mitigate the deleterious effects of the pandemic. Nevertheless, efforts are still needed to decrease lethality, mortality, and incidence trends, and ultimately to achieve control of the COVID-19 pandemic in the region. [ABSTRACT FROM AUTHOR]

Introduction: the new coronavirus (COVID-19) disease has been causing economic and health system impacts worldwide, triggering humanitarian crises in vulnerable regions, marked by high mortality rates of the disease. Brazil has been suffering an increase in the number of cases, characteristic of the formation of a second wave, with great epidemiological differences observed in the most diverse regions of the country. Many studies illustrate the behaviour of COVID-19 in the state of São Paulo, but there are gaps in the scientific literature on the epidemiology of COVID-19 in municipalities of the São Paulo metropolitan region that constitute an important industrial pole in Latin America, such as the region of Grande ABC. Objective: to evaluate mortality and lethality trends of COVID-19 during the period March 2020 to July 2021, in municipalities on region of Grande ABC, metropolitan region of São Paulo, Brazil, divided into two periods (March to November 2020 and December to July 2021). Methods: we conducted an ecological time series study with population data from the Brazilian Ministry of Health. We collected the number of cases and deaths confirmed for COVID-19 in the municipalities that make up the region of Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo, and São Caetano do Sul) from March 2020 to July 2021. Prais-Winsten linear regression was performed, and the percentage of daily change was calculated. Differences were considered significant when p<0.05. Results: in region of Grande ABC, in the period analysed, 217,264 cases and 10,004 deaths of COVID-19 were recorded. Although the mortality rate remained stationary during the first wave (March to November 2020) and the second wave (December 2020 to July 2021); lethality transitioned from decreasing during the first wave to increasing during the second wave, with rates varying according to municipality. Conclusion: trend analyses in incidence, mortality, and lethality rates assist in understanding the behaviour of the COVID-19 Pandemic in the region known as Grande ABC. Efforts must be maintained throughout the region to control the Pandemic. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 impacted health systems worldwide; the virus quickly spread in Brazil, reaching its 27 Federative units peculiarly. The northern country region recorded the lowest number of cases and accumulated deaths from the disease. However, it is a region of sizeable territorial extension and low demographic density, marked by socioeconomic inequalities and vulnerable groups, such as indigenous tribes, riverine peoples, and quilombolas. Sociodemographic factors may contribute to the dissemination of the coronavirus in this territory; thus, studies are needed to analyze the epidemiological indicators related to the pandemic. Objective: to evaluate incidence, mortality, and case fatality of COVID-19 trends in the state of Amapá, Brazil, from March 2020 to April 2021. Methods: an ecological time-series study was conducted with publicly accessible data from the Health Department of the State of Amapá. Incidence and mortality rates per 100,000 inhabitants and percentage case fatality were calculated. Crude rates were calculated by municipalities, age, and sex, per month. The Prais-Winsten regression test was performed, and the trends of monthly rates were classified as increasing, decreasing, or flat. Results: during the study period, there were 99.936 cases and 1,468 deaths accumulated by COVID-19 in the State of Amapá, Brazil. Macapá and Santana's cities, which have the highest demographic density and Human Development Index (HDI), had the highest number of cases and deaths. The most vulnerable population was elderly males aged 70 years or over; these individuals had the highest cumulative incidence, case fatality, and mortality rates. The second wave of the disease (October 2020 to April 2021) illustrated a more aggravating scenario, with increasing incidence and mortality rates. Conclusion: the COVID-19 pandemic in the state of Amapá, Brazil, is in increasing evolution, which illustrates that non-pharmacological prevention measures and acceleration of vaccination must be strengthened to avoid the development of future waves of the disease. [ABSTRACT FROM AUTHOR]

Introduction: the growth of coronavirus indices in the North region highlights the region's historical social inequalities and the problems in accessing citizenship. Objective: to analyze the mortality and lethality of COVID-19 in the state of Pará, Brazil. Methods: this is an ecological study with a time series design of secondary data. All registered cases and deaths reported by COVID-19 in the period from March 2020 to June 2021, in the state of Pará, Brazil, were considered. The incidence and mortality and lethality rates were used. The daily percentage variation and their respective 95% confidence intervals were estimated. Results: the total number of confirmed cases and deaths from COVID-19 in the state of Pará was 552,937 and 15,469, respectively, from March 2020 to June 2021. Incidence and mortality rates from March 2020 to June 2021 were, respectively, 6,407.9 and 179.3 per 100,000 inhabitants and the lethality was 43.3. Regarding the analysis of the daily trend of rates in the period from March 2020 to June 2021, both mortality and incidence increased. Conclusion: it was found that the behavior of the trend of rates in the first wave was increasing in the incidence of confirmed cases and the lethality decreasing, and in the second wave, the mortality and lethality rates were increasing. [ABSTRACT FROM AUTHOR]

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Resumo Objetivo Analisar a associação entre as desigualdades sociais e sanitárias, condições socioeconômicas, segregação espacial e letalidade por COVID-19 em Fortaleza, Ceará, Brasil. Métodos Estudo ecológico de casos confirmados e óbitos por COVID-19, tendo como unidades de análise os 119 bairros de Fortaleza. Calcularam-se os indicadores de incidência, mortalidade e letalidade aparente por COVID-19, entre 1º de janeiro e 8 de junho de 2020. Indicadores socioeconômicos foram extraídos do Censo Demográfico do Brasil de 2010. Foi realizada análise espacial e calculados índice global e local de Moran. Resultados Foram encontrados 22.830 casos confirmados, 2.333 óbitos e uma letalidade aparente de 12,7% (IC95% 11,6;13,9). Observaram--se autocorrelações espaciais significativas para letalidade aparente (I=0,35) e extrema pobreza (I=0,51), sobrepostas em diversos bairros da cidade. Conclusão A letalidade aparente por COVID-19 está associada a piores condições socioeconômicas e de saúde, demonstrando a relação entre desigualdades sociais e desfechos de saúde em tempos de pandemia.

Introduction: CoV infections can potentially cause from a simple cold to a severe respiratory syndrome, such as the Severe Acute Respiratory Syndrome and the Middle East Respiratory Syndrome (MERSCoV). The COVID-19 created a new reality for global healthcare models. Objetive: To evaluate trends in case-fatality rates of COVID-19 in the World. Methods: We conducted a population-based time-series study using public and official data of cases and deaths from COVID-19 in Argentina, Australia, Brazil, Chile, China, Colombia, France, Germany, India, Iran, Italy, Japan, Mexico, Morocco, New Zealand, Nigeria, Peru, Saudi Arabia, South Africa, South Korea, Spain, Switzerland, United Kingdom, United States and Russian, between December, 2019 and August, 2020. Data were based on reports from European Centre for Disease Prevention and Control. COVID-19 was defined by the International Classification of Diseases, 10th revision (U07.1). A Prais-Winsten regression model was performed and the Daily Percentage Change (DPC) calculated determine rates as increasing, decreasing or flat. Results: During the study period, trends in case-fatality rates in the world were flat (DPC = 0.3; CI 95% [-0.2: 0.7]; p = 0.225). In Africa, Morocco had decreasing trends (DPC = -1.1; CI 95% [-1.5: -0.7]; p < 0.001), whereas it were increasing in South Africa (p < 0.05) and flat in Nigeria (p > 0.05). In the Americas, Argentina showed a decreasing trend in case-fatality rates (DPC = -0.6; CI 95% [-1.1: -0.2]; p = 0.005), the U.S. had flat trends (p > 0.05) and all other American countries had increasing trends (p < 0.05). In Asia, Iran had decreasing trends (DPC = -1.5; CI 95% [-2.6 : -0.2]; p = 0.019); China and Saudi Arabia showed increasing trends (p < 0.05), while in India, Japan and South Korea they were flat (p > 0.05). European countries had mostly increasing trends (p < 0.05): Germany, Italy, Spain, the UK and Russia; France and Switzerland had flat trends (p > 0.05). Finally, in Oceania, trends in case-fatality rates were flat in Australia (p > 0.05) and increasing in New Zealand (p < 0.05). Conclusion: Trends in case-fatality rates of COVID-19 in the World were flat between December, 31 and August, 31. Argentina, Iran and Morocco were the only countries with decreasing trends. On the other hand, South Africa, Brazil, Canada, Chile, Colombia, Mexico, Peru, China, Saudi Arabia, Germany, Spain, United Kingdom, Russian and New Zealand had increasing trends in case-fatality rate. All the other countries analyzed had flat trends. Based on case-fatality rate data, our study supports that COVID-19 pandemic is still in progress worldwide. [ABSTRACT FROM AUTHOR]

The "mollejas de pollo al sillao" is a traditional Peruvian dish, originally from the city of Trujillo (Peru), highly appreciated for its pleasant flavor. With the design of this product you can take advantage of the proteins, iron and other nutrients it contains. In this study the effect of the vinegar concentration and the size of the piece was evaluated by using a complete 3x2 factorial design. The raw material and treatments studied were characterized physicochemically. The sensory evaluation of color, taste and texture was made through the ranking test. The selected condition for the design of the product was 100 mL/kg of vinegar and pieces of ¼ unit, showing optimal physicochemical and sensory characteristics for its commercialization. The final product contained: protein (13,45%), fat (10,40%), humidity (67,49), ashes (1,82) and pH (5,14); it also had scores of flavor (4,23), color (4,53) and texture (4,27). The sterilization process time was 35 min and lethality 9,882 min, in a party type container. [ABSTRACT FROM AUTHOR]

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This article presents an evaluation of the embryotoxicity of a new mixed polymeric formulation containing DEET as a repellent active ingredient. DEET is the most commonly used repellent against the Aedes aegypti mosquito, which transmits diseases such as dengue, Zika, and Chikungunya. However, formulations containing DEET have a high capacity for skin permeation, which can cause toxicity, especially in children and pregnant women. The study evaluated the toxicity of the new formulation using the embryonic-larval stage of zebrafish as a model. The results showed that the new formulation had lower toxicity compared to DEET and the individually evaluated polymers. However, the formulation still caused sublethal effects, such as a reduction in larval length and deformities in the tail. [Extracted from the article]

Lethality and Business Illegalisms on a Triple South American Border: A First Approximation discusses the relationship between illegalisms and lethality through research conducted in the city of Tabatinga (AM), located in the border between Brazil, Colombia, and Peru. Firstly, it introduces three aspects often associated with the city and used to characterize it as a problematic place: homicides, cocaine markets, and institutional density. Secondly, an alternate hypothesis is formulated to re-situate the issue under different empirical-analytical parameters, seeking to highlight the political and economic networks that regulate the cocaine market and produce lethal effects through pistolagem and extermination groups. [ABSTRACT FROM AUTHOR]

Objetivo: Avaliar o perfil epidemiológico das vítimas de traumatismo cranioencefálico (TCE) que tiveram internação hospitalar em instituições cobertas pelo Sistema Único de Saúde – SUS, de 2000 a 2011. Método: Pesquisa descritiva com abordagem quantitativa. Utilizaram-se dados secundários provenientes do Sistema de Informações Hospitalares (SIH-SUS). Para o estudo, foram utilizados: taxa de internações por TCE por idade, sexo, ano, mês e duração da internação, óbitos hospitalares, diagnóstico secundário e valor da internação. Para fins de análise, foi utilizado o programa Tabwin. Resultados: O coeficiente de hospitalização em Sergipe variou de 22,8 a 38,1 por 100.000 habitantes e o coeficiente de mortalidade hospitalar foi de 4,5 por 100.000 habitantes por ano. As internações concentraram-se em homens (82,2%) e entre 20 a 39 anos (43,3%). A maior causa de internação e óbitos foram as causas cuja intenção é indeterminada (36,6% das internações e 42,4% dos óbitos), seguidas pelos acidentes de trânsito (33,2% e 32%, respectivamente). A letalidade hospitalar foi de 13,7%, sendo as agressões físicas e a faixa etária idosa as circunstâncias mais relacionadas ao óbito hospitalar. Conclusões: É necessário conhecer perfil da população acometida para traçar estratégias individuais e coletivas de prevenção desses agravos. O uso dos bancos de dados disponíveis é uma ferramenta valiosa nesse contexto.

Background: End-stage kidney disease patients continue to have markedly increased cardiovascular disease morbidity and mortality. Analysis of genetic factors connected with the renin-angiotensin system that influences the survival of the patients with end-stage kidney disease supports the ongoing search for improved outcomes. Objective: To assess survival and its association with the polymorphism of renin-angiotensin system genes: angiotensin I-converting enzyme insertion/deletion and angiotensinogen M235T in patients undergoing hemodialysis. Methods: Our study was designed to examine the role of renin-angiotensin system genes. It was an observational study. We analyzed 473 chronic hemodialysis patients in four dialysis units in the state of Rio de Janeiro. Survival rates were calculated by the Kaplan-Meier method and the differences between the curves were evaluated by Tarone-Ware, Peto-Prentice, and log rank tests. We also used logistic regression analysis and the multinomial model. A p value ≤ 0.05 was considered to be statistically significant. The local medical ethics committee gave their approval to this study. Results: The mean age of patients was 45.8 years old. The overall survival rate was 48% at 11 years. The major causes of death were cardiovascular diseases (34%) and infections (15%). Logistic regression analysis found statistical significance for the following variables: age (p = 0.000038), TT angiotensinogen (p = 0.08261), and family income greater than five times the minimum wage (p = 0.03089), the latter being a protective factor. Conclusions: The survival of hemodialysis patients is likely to be influenced by the TT of the angiotensinogen M235T gene.

OBJECTIVE: To describe the case-fatality rate (CFR) and risk factors of death in children with community-acquired acute pneumonia (CAP) in a pediatric university hospital. METHOD: A longitudinal study was developed with prospective data collected from 1996 to 2011. Patients aged 1 month to 12 years were included in the study. Those who left the hospital against medical orders and those transferred to ICU or other units were excluded. Demographic andclinical-etiological characteristics and the initial treatment were studied. Variables associated to death were determined by bivariate and multivariate analysis using logistic regression. RESULTS: A total of 871 patients were selected, of whom 11 were excluded; thus 860 children were included in the study. There were 26 deaths, with a CFR of 3%; in 58.7% of these, penicillin G was the initial treatment. Pneumococcus was the most common pathogen (50.4%). From 1996 to 2000, there were 24 deaths (93%), with a CFR of 5.8% (24/413). From 2001 to 2011, the age group of hospitalized patients was older (p = 0.03), and the number of deaths (p = 0.02) and the percentage of disease severity were lower (p = 0.06). Only disease severity remained associated to death in the multivariate analysis (OR = 3.2; 95%CI: 1.2-8.9; p = 0.02). CONCLUSION: When the 1996-2000 and 2001-2011 periods were compared, a significant reduction in CFR was observed in the latter, as well as a change in the clinical profile of the pediatric in patients at the institute. These findings may be related to the improvement in the socio-economical status of the population. Penicillin use did not influence CFR.