ABSTRACT BACKGROUND: Embolization is a promising treatment strategy for cerebral arteriovenous malformations (AVMs). However, consensus regarding the main complications or long-term outcomes of embolization in AVMs remains lacking. OBJECTIVE: To characterize the most prevalent complications and long-term outcomes in patients with AVM undergoing therapeutic embolization. DESIGN AND SETTING: This systematic review was conducted at the Federal University of Alagoas, Arapiraca, Brazil. METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Data were obtained from MEDLINE, PubMed, LILACS, and SciELO databases, which included the epidemiological profile of the population, characteristics of the proposed therapy, complications (hemorrhagic events and neurological deficits), and long-term outcomes (modified Rankin scale pre- and post-treatment, AVM recanalization, complete obliteration, and deaths). RESULTS: Overall, the analysis included 34 articles (2,799 patients). Grade III Spetzler–Martin AVMs were observed in 34.2% of cases. Notably, 39.3% of patients underwent embolization combined with radiosurgery. The most frequently reported long-term complication was hemorrhage, which occurred in 8.7% of patients at a mean follow-up period of 58.6 months. Further, 6.3% of patients exhibited neurological deficits after an average of 34.7 months. Complete obliteration was achieved in 51.4% of the cases after a mean period of 36 months. Recanalization of AVMs was observed in 3.5% of patients. Long-term death occurred in 4.0% of patients. CONCLUSION: Embolization of AVMs is an increasingly safe strategy with low long-term complications and satisfactory outcomes, especially in patients who have undergone combination therapies. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/ Registration number CRD42020204867. BACKGROUND AVMs. . (AVMs) However longterm long term lacking OBJECTIVE SETTING Alagoas Arapiraca Brazil METHODS MetaAnalyses Meta Analyses criteria MEDLINE PubMed LILACS databases population therapy hemorrhagic deficits, , deficits) modified pre posttreatment, posttreatment post treatment, post-treatment recanalization deaths. deaths deaths) RESULTS Overall 3 2,799 2799 2 799 (2,79 patients) SpetzlerMartin Spetzler Martin 342 34.2 Notably 393 39 39.3 radiosurgery hemorrhage 87 8 7 8.7 followup follow up 586 58 6 58. months Further 63 6.3 347 34. 514 51 4 51.4 35 5 3.5 Longterm Long 40 0 4.0 CONCLUSION therapies REGISTRATION https//www.crd.york.ac.uk/prospero/ httpswwwcrdyorkacukprospero https //www.crd.york.ac.uk/prospero/ www crd york ac uk prospero https://www.crd.york.ac.uk/prospero CRD42020204867 CRD (AVMs 2,79 279 79 (2,7 39. 8. 6. 51. 3. 4. https//www.crd.york.ac.uk/prospero wwwcrdyorkacukprospero //www.crd.york.ac.uk/prospero CRD4202020486 2,7 27 (2, CRD420202048 2, (2 CRD42020204 ( CRD4202020 CRD420202 CRD42020 CRD4202 CRD420 CRD42 CRD4

Abstract Background The delay in recognizing stroke symptoms is a significant obstacle to receiving acute treatment. Therefore, it is essential to understand the gaps in the knowledge about stroke among the general population and promote campaigns based on these gaps. Objective To investigate the general knowledge about stroke in a capital in Northeastern Brazil in a sample of individuals who attended a public hospital and the impacts of the coronavirus disease 2019 (COVID-19) pandemic on the use of emergency services. Methods We included patients older than 18 years of age and their family members and/or companions. After obtaining consent, the researcher presented a typical case of stroke, and the participants filled out a questionnaire divided into 2 sections: sociodemographic data and 15 questions about stroke detection and seeking health services and treatment. Results We included 154 individuals with a mean age of 44.45 ± 16.21 years. After presenting the case, 60.4% mentioned the acronym AVC (acidente vascular cerebral, or cerebrovascular accident [stroke], in Portuguese) as a possible explanation, and 54.5% reported that they would call the Mobile Emergency Care Service. However, 62.9% provided the incorrect telephone number for the Mobile Emergency Care Service or lacked knowledge of the accurate number. Regarding the risk factors for stroke, 27.9% did not know any of them, 65.5% were unaware of any treatment, and no reference was made to thrombolytic therapy. About their chosen conduct in the same case in the context of the COVID-19 pandemic, 98.1% of the participants would not change their behavior. Conclusion These results can assist in the planning of public policies and campaigns emphasizing the issue of risk factors and how to access emergency medical services in the state of Alagoas, Brazil. treatment Therefore 201 COVID19 COVID 19 (COVID-19 1 andor companions consent sections 4445 44 45 44.4 1621 16 21 16.2 604 60 4 60.4 acidente cerebral , [stroke] Portuguese explanation 545 54 5 54.5 However 629 62 9 62.9 279 27 27.9 them 655 65 65.5 therapy COVID-1 981 98 98.1 behavior Alagoas 20 COVID1 (COVID-1 444 44. 162 16. 6 60. [stroke 54. 62. 27. 65. COVID- 98. (COVID- (COVID

Resumo Antecedentes O atraso no reconhecimento dos sinais do acidente vascular cerebral (AVC) é um dos principais obstáculos para receber o tratamento de fase aguda. Portanto, é importante compreender as lacunas no conhecimento da população sobre o AVC e promover campanhas de acordo com essas lacunas. Objetivo Investigar o conhecimento geral sobre o AVC em uma amostra de indivíduos acompanhados em um hospital público de uma capital do Nordeste brasileiro e o impacto da pandemia de doença do coronavírus 2019 (coronavirus disease 2019 - COVID-19, em inglês) na utilização dos serviços de emergência. Métodos Foram incluídos pacientes acima de 18 anos e seus acompanhantes e/ou familiares. Após a assinatura do termo de consentimento, o pesquisador apresentou um caso típico de AVC, e os participantes responderam um questionário dividido em 2 partes: dados sociodemográficos e 15 perguntas sobre o reconhecimento do AVC, procura por serviços de saúde e tratamento. Resultados Foram incluídos 154 participantes com idade média de 44,45 ± 16,21 anos. Após a apresentação do caso, 60,4% mencionaram AVC como uma possível explicação, e 54,5% chamariam o Serviço de Atendimento Móvel de Urgência (SAMU). Entretanto, 62,9% erraram ou não sabiam o número do SAMU. Quanto aos fatores de risco de desenvolver AVC, 27,9% não sabiam identificar nenhum, 65,5% não conheciam qualquer tratamento, e não houve menção ao tratamento trombolítico. Com relação à conduta no mesmo caso, mas no contexto da pandemia de COVID-19, 98,1% dos participantes não mudariam sua conduta. Conclusão Os resultados deste estudo podem auxiliar no planejamento de políticas públicas com ênfase em campanhas sobre os fatores de risco e o acionamento do SAMU em Alagoas, Brasil. (AVC aguda Portanto 201 coronavirus COVID19, COVID19 COVID 19, 19 COVID-19 inglês emergência 1 eou familiares consentimento partes 4445 44 45 44,4 1621 16 21 16,2 604 60 4 60,4 explicação 545 54 5 54,5 . (SAMU) Entretanto 629 62 9 62,9 279 27 27,9 nenhum 655 65 65,5 trombolítico 981 98 98,1 Alagoas Brasil 20 COVID1 COVID-1 444 44, 162 16, 6 60, 54, (SAMU 62, 27, 65, 98, COVID-

SUMMARY OBJECTIVE: The aim of this study was to measure the reliability, internal consistency, and construct validity of the Kidney Symptom Questionnaire for the Brazilian population. METHODS: This is a cross-cultural adaptation and questionnaire validation study. We included native Brazilians of both sex aged>18 years, as well as hypertensive and/or diabetic patients. All participants were assessed using Screening for Occult Renal Disease, EuroQol 5 Dimensions, 36-Item Short Form Survey, and the Kidney Symptom Questionnaire. We used Spearman’s coefficient (rho) to measure the correlations between the Kidney Symptom Questionnaire and other instruments; Cronbach’s alpha to measure internal consistency; and intraclass correlation coefficient, standard error of measurement, and minimum detectable change to measure test-retest reliability. RESULTS: The sample was formed by 121 adult participants, mostly female, with systemic arterial hypertension and/or diabetes mellitus. We found excellent reliability (intraclass correlation coefficient≥0.978), adequate internal consistency (Cronbach’s alpha≥0.860), and adequate construct validity on the Kidney Symptom Questionnaire domains; besides, we observed significant correlations between the Kidney Symptom Questionnaire and other instruments. CONCLUSION: The Brazilian version of the Kidney Symptom Questionnaire has adequate measurement properties to assess chronic/occult kidney disease in patients who do not require renal replacement therapy. OBJECTIVE population METHODS crosscultural cross cultural aged18 aged 18 aged>1 years andor or Disease Dimensions 36Item Item 36 Survey Spearmans Spearman s rho (rho instruments Cronbachs Cronbach testretest test retest RESULTS 12 female mellitus coefficient≥0.978, coefficient0978 coefficient≥0.978 , 0 978 coefficient≥0.978) alpha≥0.860, alpha0860 alpha≥0.860 860 alpha≥0.860) domains besides CONCLUSION chronicoccult chronic occult therapy aged1 1 aged> 3 coefficient097 coefficient≥0.97 97 alpha086 alpha≥0.86 86 coefficient09 coefficient≥0.9 9 alpha08 alpha≥0.8 8 coefficient0 coefficient≥0. alpha0 alpha≥0. coefficient≥0 alpha≥0 coefficient≥ alpha≥

Abstract Background Self-care in the management of systemic arterial hypertension (SAH) is crucial, and validated instruments can help researchers and health professionals to plan strategies to improve self-care in people with SAH. Objective The main objective of this study was to translate, cross-culturally adapt, and validated the Hypertension Self-Care Profile (HBP-SCP) for Brazilian Portuguese. Methods The translation and cross-cultural adaptation was performed in five phases, and the pre-final version was tested in 30 individuals, native speakers of Portuguese with a diagnosis of hypertension. The final version was administered in 100 individuals. The inclusion criteria were: diagnosis of SAH, characterized by systolic arterial blood pressure ≥ 140 mmHg and/or diastolic arterial blood pressure ≥ 90mmHg, regular use of antihypertensive medications and over 18 years of age. The present study also used two other questionnaires, previously validated for the Brazilian population, to verify the validity of the construct, the Healthy Habits Perception Questionnaire (HHPQ) and the Quality of Life in Hypertension Mini-Questionnaire (MINICHAL-BRASIL). Results During the translation and cross-cultural adaptation phase, there were no disagreements. Adequate reliability — intraclass correlation coefficient (ICC) ≥ 0.89, standard error of measurement (SEM) % ≤ 4.34, minimum detectable change (MDC) % ≤ 12.04 — and internal consistency (Cronbach's alpha ≥ 0.75) were observed. The behavior domain of HBP-SCP obtained significant correlations (p < 0.05) with the self-efficacy domain and HHPQ; the motivation domain with the self-efficacy domain; and the self-efficacy domain with the somatic manifestation domain of MINICHAL-BRASIL. No ceiling and floor effects were observed. Conclusions The Brazilian Portuguese version of the HBP-SCP has adequate psychometric properties, according to the best scientific recommendations. Selfcare Self care SAH (SAH crucial selfcare self translate crossculturally cross culturally adapt SelfCare Care HBPSCP HBP SCP (HBP-SCP crosscultural cultural phases prefinal pre 3 individuals 10 14 andor or 90mmHg 1 age questionnaires population construct HHPQ (HHPQ MiniQuestionnaire Mini MINICHALBRASIL. MINICHALBRASIL MINICHAL BRASIL . (MINICHAL-BRASIL) phase disagreements ICC (ICC 089 0 89 0.89 SEM (SEM 434 4 34 4.34 MDC (MDC 1204 12 04 12.0 Cronbachs Cronbach s 0.75 075 75 observed p 0.05 005 05 selfefficacy efficacy BRASIL. MINICHAL-BRASIL properties recommendations (MINICHAL-BRASIL 08 8 0.8 43 4.3 120 12. 0.7 07 7 0.0 00 0. 4.

RESUMEN La satisfacción laboral es multifactorial y está directamente relacionada con la calidad de los servicios de salud. El objetivo principal de este estudio fue identificar el nivel de satisfacción y el contexto de trabajo de equipos multidisciplinarios en servicios especializados de rehabilitación en el estado de Alagoas, Brasil. Se evaluó el perfil profesional y el perfil sociodemográfico, y se aplicaron la Escala de Evaluación del Contexto de Trabajo (EACT), dividida en tres dimensiones, y preguntas adaptadas de las dimensiones de satisfacción y remuneración de la metodología de encuesta de clima organizacional, Great Place to Work. Se incluyeron a 190 profesionales, de los cuales el 86,3% eran mujeres, y la edad media fue de 35,47±9,25 años. La mayoría trabajaba en la capital (60%) y el 84,7% ganaba entre R$1.000 y R$3.000. La dimensión “organización del trabajo” fue crítica. Los ítems “ritmo de trabajo”, “exigencia de resultados”, “control del rendimiento” y “tareas repetitivas” obtuvieron los peores resultados, pero el 92,7% de los participantes estaban satisfechos con su actividad profesional. La regresión logística mostró que a más años de formación y puntuaciones más bajas en las dimensiones “condiciones de trabajo” y “relación socioprofesional” se asociaban a una mayor satisfacción laboral. La satisfacción laboral fue alta, la dimensión “organización del trabajo” crítica, y casi la mitad de los participantes había pensado en dejar su carrera. salud Alagoas Brasil sociodemográfico EACT, EACT , (EACT) organizacional Work 19 profesionales 863 86 3 86,3 mujeres 3547925 35 47 9 25 35,47±9,2 60% 60 (60% 847 84 7 84,7 R1000 R 1 000 R$1.00 R3000 R$3.000 organización crítica ritmo trabajo, exigencia resultados resultados” control rendimiento tareas repetitivas 927 92 92,7 condiciones relación socioprofesional alta carrera (EACT 8 86, 354792 4 2 35,47±9, 6 (60 84, R100 00 R$1.0 R300 R$3.00 92, 35479 35,47±9 (6 R10 0 R$1. R30 R$3.0 3547 35,47± ( R1 R$1 R3 R$3. 354 35,47 R$ R$3 35,4 35,

ABSTRACT Job satisfaction is multifactorial and is directly related to the quality of health services. The main objective of this study was to characterize the level of job satisfaction and the work context of the multidisciplinary teams in specialized rehabilitation services in the state of Alagoas, Brazil. We evaluated the professional profile of participants and sociodemographic information. The Work Context Assessment Scale (WCAS) which is divided into three dimensions and questions adapted from the satisfaction and remuneration dimensions of the Great Place to Work methodology for the Organizational Climate Survey, was used. We included 190 professionals, the mean age was 35.47±9.25 and 86.3% were women. Most participants worked in the capital (60%) and 84.7% had a monthly wage ranging from R$1,000 to R$3,000. The dimension of “work organization” was crucial. The items “pace of work,” “strong demand,” “performance monitoring,” and “repetitive tasks” presented the worst results, but 92.7% are satisfied with their professional activities. The logistic regression analysis showed that more years since graduation and lower scores of Work conditions and Socio-professional relationships were associated with higher job satisfaction. Job satisfaction was found to be high, the dimension of work organization was crucial, and almost half of the participants have already thought about leaving their careers. Alagoas Brazil information WCAS (WCAS Survey used 19 professionals 3547925 35 47 9 25 35.47±9.2 863 86 3 86.3 women 60% 60 (60% 847 84 7 84.7 R1000 R 1 000 R$1,00 R3000 R$3,000 crucial pace work, strong demand, demand performance monitoring, monitoring repetitive tasks results 927 92 92.7 activities Socioprofessional Socio high careers 354792 4 2 35.47±9. 8 86. 6 (60 84. R100 00 R$1,0 R300 R$3,00 92. 35479 35.47±9 (6 R10 0 R$1, R30 R$3,0 3547 35.47± ( R1 R$1 R3 R$3, 354 35.47 R$ R$3 35.4 35.

RESUMO A satisfação no trabalho é multifatorial e está diretamente relacionada com a qualidade dos serviços de saúde. O objetivo principal deste estudo foi caracterizar o nível de satisfação e o contexto de trabalho de equipes multidisciplinares de serviços especializados em reabilitação no estado de Alagoas, Brasil. Foi avaliado o perfil profissional e sociodemográfico e foram aplicadas a escala de avaliação do contexto de trabalho (EACT), que é dividida em três dimensões, e questões adaptadas das dimensões de satisfação e remuneração da metodologia Great Place to Work da pesquisa de clima organizacional. Incluímos 190 profissionais, sendo 86,3% do sexo feminino, e a idade média foi de 35,47±9,25 anos. A maioria trabalhava na capital (60%) e 84,7% recebiam mensalmente de R$ 1.000,00 a R$ 3.000,00. A dimensão organização do trabalho foi considerada crítica. Os itens ritmo de trabalho, cobrança por resultados, fiscalização do desempenho e tarefas repetitivas tiveram os piores resultados, mas 92,7% dos participantes estavam satisfeitos com suas atividades profissionais. A regressão logística mostrou que mais anos de formado e menores pontuações nas dimensões condições de trabalho e relações socioprofissionais estão associados com maior satisfação no trabalho. A satisfação no trabalho foi alta, a dimensão organização do trabalho crítica, e quase metade dos participantes já pensaram em deixar sua carreira. saúde Alagoas Brasil EACT, EACT , (EACT) organizacional 19 profissionais 863 86 3 86,3 feminino 3547925 35 47 9 25 35,47±9,2 60% 60 (60% 847 84 7 84,7 R 100000 1 000 00 1.000,0 300000 3.000,00 crítica resultados 927 92 92,7 alta carreira (EACT 8 86, 354792 4 2 35,47±9, 6 (60 84, 10000 0 1.000, 30000 3.000,0 92, 35479 35,47±9 (6 1000 1.000 3000 3.000, 3547 35,47± ( 100 1.00 300 3.000 354 35,47 10 1.0 30 3.00 35,4 1. 3.0 35, 3.

RESUMO Antecedentes Até o momento existe pouca informação disponível na literatura sobre a epidemiologia do acidente vascular verebral (AVC) no nordeste brasileiro. Objetivo Investigar a prevalência dos subtipos de AVC, dos fatores de risco para doenças cerebrovasculares e o manejo do AVC em um serviço público especializado em Alagoas. Método Os dados foram coletados de forma prospectiva e consecutiva de pacientes com diagnóstico de AVC em um ambulatório especializado em neurovascular, de novembro de 2016 a junho de 2018. Recorrência do AVC foi avaliada por telefone 12 meses após a inclusão no estudo. Resultados Foram avaliados 190 pacientes, idade média de 60,22(13,29 anos, 60,5% homens. AVC isquêmico foi o subtipo mais comum (85,2%). Sedentarismo foi o fator de risco mais prevalente (71,6%), seguido de hipertensão (62,6%) e história familial de AVC (41,1%). Somente 21,5% dos pacientes foram transportados por ambulância até o hospital e 42,6% receberam o primeiro atendimento em serviço médico sem suporte de exame de imagem. A mediana do NIHSS foi 2,5 (IQR, 1-3). Encontramos alta prevalência de AVC indeterminado (35,8%) e poucos pacientes completaram a investigação etiológica. Após um ano da inclusão no estudo, 12 pacientes (6,3%) morreram e 14 (7,3%) tiveram outro AVC. Conclusão A prevalência dos fatores de risco para doenças cerebrovasculares e a apresentação clínica foram similares a séries prévias. Um número expressivo de pacientes recebeu atendimento médico em locais sem exames de imagem. Houve alto número de pacientes com AVC indeterminado, o que mostra a dificuldade de acesso ao sistema de saúde em Alagoas.

ABSTRACT Background There is little information available on stroke epidemiology in the northeast of Brazil. Objective Our objective was to investigate the prevalence of the stroke subtypes, prevalence of cerebrovascular risk factors and patterns of management in a public neurovascular outpatient referral service, in Alagoas. Methods Data were prospectively collected from consecutive patients with stroke who were treated in a specialized neurovascular clinic between November 2016 and June 2018. Recurrence was evaluated by telephone 12 months after patients had been included in the study. Results We evaluated 190 patients (mean age, 60.22 ( 13.29 years; 60.5% males). Ischemic stroke was the most frequent subtype (85.2%). Sedentary lifestyle was the most common risk factor (71.6%), followed by hypertension (62.6%) and stroke family history (41.1%). Only 21.5% of the patients were transported by ambulance to the hospital, and 42.6% received medical support in hospital units or emergency units with no imaging support. The median NIHSS was 2.5 (IQR, 1-5) and mRS was 2 (IQR, 1-3). We found a high rate of undetermined stroke (35.8%), and few patients completed the etiological investigation. One year after inclusion in the study, 12 patients (6.3%) had died and 14 (7.3%) had had another stroke. Conclusions The prevalence of cerebrovascular risk factors and clinical presentation were similar to what had been seen in previous series. A notable number of patients received medical support in institutions with no imaging equipment. The high number of cases of undetermined stroke etiology shows the difficulty in accessing healthcare services in Alagoas.

Resumo Hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) são dois dos principais fatores de risco para a mortalidade por COVID-19. Descrever a prevalência e o perfil clínico-epidemiológico de óbito por COVID-19 ocorridos em Pernambuco, Brasil, entre 12 de março e 14 de maio de 2020 entre pacientes que possuíam hipertensão arterial sistêmica e/ou diabetes mellitus como doenças prévias. Estudo observacional transversal. Foram analisadas as seguintes variáveis: município de procedência, sexo, faixa etária, tempo entre o início dos sinais/sintomas e o óbito, sinais/sintomas, tipo de comorbidades e hábitos de vida. Variáveis categóricas foram descritas por meio de frequências e variáveis contínuas por meio de medidas de tendência central e de dispersão. Os testes de Mann-Whitney e Kruskal-Wallis foram utilizados. Dos 1.276 registros incluídos no estudo, 410 apresentavam HAS e/ou DM. A prevalência de HAS foi 26,5% (n=338) e de DM foi 19,7% (n=252). Dos registros, 158 (12,4%) eram de pacientes que possuíam somente HAS, 72 (5,6%) somente DM e 180 (14,1%) apresentavam HAS e DM. Dos indivíduos com HAS, 53,3% apresentavam DM e 71,4% dos diabéticos apresentam HAS. A mediana (em dias) do tempo entre o início dos sinais/sintomas e o desfecho óbito foi 8,0 (IIQ 9,0), sem diferença significativa entre os grupos de comorbidades (p=0,633), sexo (p=0,364) e faixa etária (p=0,111). Observou-se maior prevalência de DM e HAS na população masculina (DM — 61,3% eram homens e 38,9% mulheres; HAS — 53,2% eram homens e 46,8% mulheres). Os sinais/sintomas mais frequentes foram dispneia (74,1%; n=304), tosse (72,2%; n=296), febre (68,5%; n=281) e saturação de O2<95% (66,1%; n=271). Dos hipertensos, 73,3% (n=100) apresentavam outras comorbidades/fatores de risco associados, e 54,2% (n=39) dos diabéticos apresentavam outras comorbidades/fatores de risco associados. Destacaramse as cardiopatias (19,5%; n=80), obesidade (8,3%; n=34), doença respiratória prévia (7,3%; n=30) e nefropatia (7,8%; n=32). A prevalência de tabagismo foi 8,8% (n=36) e de etilismo alcançou 3,4% (n=14). O estudo mostrou que a prevalência de HAS foi superior à prevalência de DM nos indivíduos que foram a óbito por COVID-19. Em idosos, a prevalência foi superior à observada em indivíduos não idosos.

ABSTRACT BACKGROUND: Stroke is the principal cause of disability around the world and the ensuing functional dependence (FD) can be correlated with different factors. OBJECTIVE: To determine how demographic factors and clinical characteristics after stroke distinguish patients who achieve functional independence from those who do not. DESIGN AND SETTING: Observational study at specialized neurovascular clinic in Alagoas, Brazil. METHODS: FD was classified according to the modified Rankin scale (mRs): 0 to 2 points were classified as independent (FD-), and 3 to 5 points were classified as dependent (FD+). Logistic regression analysis included age, sedentary lifestyle, the Center for Epidemiological Studies – Depression Scale (CES-D) and the National Institutes of Health Stroke Scale (NIHSS). The Mann-Whitney test and χ2 test were used to compare groups. RESULTS: We included 190 stroke patients with a mean age of 60.02 ± 14.22 years. We found that 34.8% of the patients were classified as FD+. Lower NIHSS and CES-D scores were more associated with achieving functional independence. Most of the patients had access to physical therapy, and the mean duration of rehabilitation therapy was 65.2 minutes per week. Females had higher prevalence of depressive symptoms (P = 0.005) and rehabilitation time was shorter for hemorrhagic stroke (P = 0.02). CONCLUSION: We found a FD rate four times greater than in another Brazilian study. Lower stroke severity and fewer depressive symptoms were associated with achieving functional independence. Less than half of the patients were referred to a rehabilitation service at hospital discharge and few had access to multidisciplinary treatment.

Resumo Fundamento As doenças cerebrovasculares (DCBV) constituem a segunda causa de mortes no mundo. Objetivo Analisar a tendência da mortalidade por DCVB no Brasil (1996-2015) e associação com o índice de desenvolvimento humano (IDH) e o índice de vulnerabilidade social (IVS). Métodos Trata-se de estudo ecológico envolvendo as taxas de mortalidade padronizadas por DCBV. Os dados dos óbitos foram obtidos do Sistema de Informações sobre Mortalidade e os dados populacionais, do Instituto Brasileiro de Geografia e Estatística. Para as análises temporais, foi utilizado o modelo de regressão por pontos de inflexão, sendo calculado o percentual de variação anual (annual percent change [APC]) e médio do período (average annual percent change [AAPC]), com intervalo de confiança de 95% e significância de 5%. As tendências foram classificadas em crescente, decrescente ou estacionária. O modelo de regressão multivariada foi utilizado para testar a associação entre a mortalidade por DCBV, IDH e IVS. Resultados Foram registrados 1.850.811 óbitos por DCBV no período estudado. Observou-se redução da taxa de mortalidade nacional (APC: -2,4; p = 0,001). Vinte unidades federativas apresentaram tendências significativas, sendo 13 de redução, incluindo todos das regiões Centro-Oeste (n = 4), Sudeste (n = 4) e Sul (n = 3). O IDH teve associação positiva e o IVS, associação negativa com a mortalidade (p = 0,046 e p = 0,026, respectivamente). Conclusão O estudo mostrou comportamento epidemiológico desigual da mortalidade entre as regiões, sendo maior nos estados do Sudeste e Sul, porém com tendência significativa de redução, e menor nos estados do Norte e Nordeste, mas com tendência significativa de crescimento. O IDH e o IVS associaram-se com a mortalidade. (Arq Bras Cardiol. 2021; 116(1):89-99)

Abstract Background Cerebrovascular diseases (CBVD) are the second major cause of death in the world. Objective To analyze the mortality trend of CBVD in Brazil (1996 to 2015) and its association with Human Development Index (HDI) and the Social Vulnerability Index (SVI). Methods This is an ecological study. We analyzed the mortality rate standardized by CBVD. Death data were obtained from the Mortality Information System (SIM) and populational data from the Brazilian Institute of Geography and Statistics (IBGE). The model of regression by inflection points (Joinpoint regression) was used to perform the temporal analysis, calculating the Annual Percent Change (APC) and Average Annual Percent Change (AAPC), with 95% of confidence interval and a significance of 5%. Trends were classified as increasing, decreasing or stationary. A multivariate regression model was used to analyze the association between mortality by CBVD, HDI and SVI. Results During this period, 1,850,811 deaths by CBVD were recorded. We observed a reduction in the national mortality rate (APC -2.4; p = 0.001). Twenty federation units showed a significant trend, of which 13 showed reduction, including all states in the Midwest (n=4), Southeast (n=4) and South (n=3). The HDI was positively associated and the SVI was negatively associated with mortality (p = 0.046 and p = 0.026, respectively). Conclusion An unequal epidemiological course of mortality was observed between the regions, being higher in the Southeast and South states, with a significative tendency of reduction, and lower in the North and Northeast states, but with a significative tendency of increase. HDI and SVI showed an association with mortality. (Arq Bras Cardiol. 2021; 116(1):89-99)

Resumo Introdução: As quedas em idosos são frequentes e um grave problema de saúde pública. A utilização de instrumentos adequados na avaliação dos idosos auxilia na detecção precoce dos indivíduos em risco de quedas e na sua prevenção. Objetivo: Verificar a ocorrência de quedas em um grupo de idosos e detectar qual o teste de equilíbrio é o mais adequado para a amostra estudada. Métodos: Trata-se de um estudo observacional, transversal do tipo quantitativo. Foram incluídos 30 idosos, acima de 60 anos participantes de um grupo de promoção da saúde. Os participantes foram inicialmente entrevistados e posteriormente avaliados por meio dos seguintes instrumentos: Escala de equilíbrio funcional de Berg (EEB), Timed Up and Go Test (TUG) e Índice Dinâmico da Marcha (DGI). Resultados: A idade média dos participantes foi de 69,30 ± 7,47 anos, 90% eram do sexo feminino e 46,7% dos indivíduos relataram quedas. Os participantes obtiveram valor médio na TUG 10,2 ± 2,5 segundos, na EEB 51,4 ± 2,6 e na DGI de 18,6 ± 4,2. A sensibilidade das escalas foi de 0,71 na TUG, 0,50 na DGI e 0,42 na EEB e a especificidade foi de 0,44 na TUG, 0,32 na DGI e de 0,63 na EEB. Conclusão: Observou-se uma alta prevalência de quedas na amostra avaliada. Além disso, o TUG foi o teste mais sensível para avaliar o equilíbrio na amostra avaliada. Entretanto, sua utilização de forma isolada merece cautela nessa amostra.

Abstract Introduction: Falls of elderly people are common, representing a serious public health problem. The use of appropriate instruments in the assessment of elderly patients supports the early detection of individuals under risk of falls and its prevention. Objective: To verify the incidence of falls in a group of elderly patients and detect which balance test is the most appropriate for the studied sample. Methods: Quantitative, cross-sectional study with an observational approach. A total of 30 elderly patients aged over 60 years old participating in a health promotion group were included in the sample. The participants were initially interviewed and subsequently assessed by means of the following instruments: Berg Balance Scale (BBS), Timed Up and Go test (TUG), and the Dynamic Gait Index (DGI). Results: The mean age of the participants was 69.30 ± 7.47 years; 90% were women and 46.7% of the individuals reported falls. The participants obtained a mean value of 10.2 ± 2.5 seconds in the TUG, 51.4 ± 2.6 in the BBS, and 18.6 ± 4.2 in the DGI. The sensitivity of the scales was 0.71 in the TUG, 0.50 in the DGI, and 0.42 in the BBS; specificity was 0.44 in the TUG, 0.32 in the DGI and 0.63 in the BBS. Conclusion: A high prevalence of falls was observed in the sample. In addition, the TUG was the most sensitive test to assess balance in the assessed sample. However, its use alone requires caution in this sample.

Objetivo Validar a Escala Clínica de Marcha e Equilíbrio (GABS) para a população brasileira com doença de Parkinson (DP) e compará-la com a Escala de Equilíbrio de Berg (BBS). Métodos 107 pacientes com diagnóstico de DP foram avaliados através das escalas versão reduzida da UPDRS motora, Hoehn e Yahr, Schwab e England, Escala de Medo de Quedas Internacional, Escala de Congelamento da Marcha, GABS e BBS. Resultados A consistência interna da escala foi 0,94, a confiabilidade inter-examinador 0,98 e intra-examinador 0,94. Curva ROC (receiver operating characteristic curve) de 0,72, com sensibilidade de 0,75 e especificidade de 0,60 para discriminar pacientes com história de queda nos últimos 12 meses, para uma nota de corte de 13 pontos. Conclusão Nosso estudo demonstra que a versão brasileira da GABS é válida para avaliar a marcha e o equilíbrio em pacientes com DP.

Objective To validate the Clinical Gait and Balance Scale (GABS) for a Brazilian population of patients with Parkinson's disease (PD) and to compare it to the Berg Balance Scale (BBS). Methods One hundred and seven PD patients were evaluated by shortened UPDRS motor scale (sUPDRSm), Hoehn and Yahr (HY), Schwab and England scale (SE), Falls Efficacy Scale International (FES-I), Freezing of Gait Questionnaire (FOG-Q), BBS and GABS. Results The internal consistency of the GABS was 0.94, the intra-rater and inter-rater reliability were 0.94 and 0.98 respectively. The area under the receiver operating characteristic (ROC) curve was 0.72, with a sensitivity of 0.75 and specificity of 0.6, to discriminate patients with a history of falls in the last twelve months, for a cut-off score of 13 points. Conclusions Our study shows that the Brazilian version of the GABS is a reliable and valid instrument to assess gait and balance in PD.