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publicado em 03/09/2013 às 12h22:00
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Death from stroke is higher in the urban city of Amazonas

The survey, conducted in FNUSP, was based on the city of Coari, where the stroke was the cause of 14% of the deaths of over 35

 
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Foto: Governo do Amazonas
Bordering usually live in family farming and subsistence fishing, not contacting factors that tend to increase the chances of a stroke
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Bordering usually live in family farming and subsistence fishing, not contacting factors that tend to increase the chances of a stroke

In the city of Coari, inside the Amazon, the Cerebrovascular Accident (CVA) was the reason for 14% of deaths in people over 35 years, between 2003 and 2010. Of all those affected by the spill in the city in one year, about 35% died within one month of the occurrence. These are the results of the study physiotherapist Tiótrefis Gomes Fernandes, Faculty of Medicine, USP (USP), which also confirmed the higher mortality among residents of urban areas, compared to coastal, rural, plus the high rate of neurological impairment . The survey also sought non-hospitalized cases, since in the region, there are difficulties in accessing treatment.

The different habits of life of the residents of the two areas may have been decisive for this difference. Local inhabitants usually live in family farming and subsistence fishing, not contacting factors that tend to increase the chances of a stroke occur or death by disease. This routine much simpler, with less contact with the urbanized life, both work rate that can generate more stress, the type of food, industrialized and richer in fat, can cause minor risk factors for cardiovascular diseases, among them stroke, and their outcomes, explains Fernandes.

The research was done in three steps. The first was the monitoring of malaria cases recorded from October 2010 to September 2011 (23 in total) at the Regional Hospital of Coari, only the municipality of about 77,000 inhabitants. The therapist observed each patient and found that 35% of people die within one month after the spill, noting: we perceive a high mortality from stroke in this population compared with others of Brazil and also abroad. The most common profile of those afflicted by the disease were men, mixed race, no formal study and earning one to two minimum wages. The average age of these patients was 73 years and almost all (95.7%) had hypertension. At this stage, it was possible that the stroke caused severe neurological deficit in 73.4% of cases.

<b> Higher the age, higher the risk </ b>

It was also made the analysis of data from the Mortality Information System (SIM), from 2003 to 2010 in the city, granted by the Ministry of Health They revealed that 14% of deaths in the area were due to stroke and confirmed that the risk of death by disease increases with increasing age of the person. Fernandes says that in rural areas having a health problem, you have to put someone on the boat, walking hours and hours on the river until you reach the hospital. Even so, 62.5% of registered deaths from the disease occurred during hospitalization. From this information, Fernandes concluded that, proportionally, the urban population is the most recorded deaths from stroke.

The search for cases in the community, the third stage of the study, was performed to get the dimension of the disease in the population. This is done because not all stroke cases admitted to hospital, says physiotherapist. Questionnaire on symptoms of stroke was applied to the population at risk, which consists of those over 35 years. There were more cases of stroke in the community between the riparian than in urban areas, maybe due to the increased survival in the rural area. Even so, there was a high prevalence in the county as a whole. The physiotherapist says his mentor, Paul Andrade Lotufo, applied the same methodology in an epidemiological study in the region of the district of Butantan in São Paulo. In São Paulo, unlike the city of Amazonas, the search phase of cases in the community found more difficulty than the step that hospital, according to Fernandes, was very good, because there was a very good control in the hospital, even the quality of attention.

There is much talk of the Amazon region, the potential, but little is studying the social question and the implication of these cultural and social differences in health problems of the people, says the therapist, who is a professor at the Federal University of Amazonas. He defended his doctoral thesis The epidemiology of cerebrovascular disease in riverside and urban populations in the Brazilian Amazon: the study of morbidity and mortality of stroke in the city of Coari-AM (EMMA-Coari) in January this year.

Source: USP
   Palavras-chave:   Death from stroke    Stroke    Stroke    Coari    Amazonas    Tiótrefis Gomes Fernandes    Faculty of Medicine    USP    USP      
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