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    Date Issued2021 (2)AuthorMartins Emmerick, Isabel Cristina (2)
    Muzy, Jessica (2)
    Campos, Monica Rodrigues (1)Genovez de Avelar, Fernando (1)Rodrigues Campos, Mônica (1)View MoreUMass Chan AffiliationDepartment of Surgery (1)Division of Thoracic Surgery, Department of Surgery (1)Document TypeJournal Article (2)KeywordHealth Services Administration (2)Health Services Research (2)coronavirus infections (1)Covid-19 (1)Diabetes Complications (1)View MoreJournalCadernos de saude publica (1)Physis: Revista de Saúde Coletiva (1)

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    Complications of Covid-19: Developments for the unified health system [Complicações da Covid-19: Desdobramentos para o sistema único de saúde]

    Genovez de Avelar, Fernando; Martins Emmerick, Isabel Cristina; Muzy, Jessica; Rodrigues Campos, Mônica (2021-11-15)
    Covid-19 is an infectious severe acute respiratory syndrome, caused by Coronavirus, which quickly reached pandemic levels. In July/2020, Brazil was the second country most affected by the disease, exceeding two million cases. Despite the increasing scientific literature on Covid-19, its containment is still compromised by the lack of understanding about its determinants and complications. This article presents a discussion on aspects related to Covid-19 complications and its effects on Unified Health System (SUS), aiming at planning new coping strategies. Additionally, it is pointed out that the overload of the health system does not result only from aspects associated with the assistance to Covid-19, but adds to the pre-existing health needs, whose care strategies were postponed and/or changed due to the actions transmission control. It is evident, then, the need to reinforce the action of Primary Health Care as the ordering of care in SUS, acting in the management of the reorganization of flows and in the improvement of the physical structures of the units. To this end, the end of measures to limit health resources is essential, since not only does the success of coping with Covid-19 depend on this, but also the future of SUS and Brazilian’s health.
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    [Prevalence of diabetes mellitus and its complications and characterization of healthcare gaps based on triangulation of studies]

    Muzy, Jessica; Campos, Monica Rodrigues; Martins Emmerick, Isabel Cristina; Silva, Raulino Sabino da; Schramm, Joyce Mendes de Andrade (2021-05-28)
    Diabetes mellitus is one of the most prevalent diseases worldwide and is among the leading causes of loss of healthy years of life, which is aggravated in Brazil by accelerated population aging. This study aims to measure the problem of diabetes mellitus and its complications and characterize healthcare for diabetics in Brazil, according to regions. Prevalence rates were estimated using a multinomial regression model, and characterization of healthcare was based on triangulation between the Brazilian National Health Survey (PNS), the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), and data from the Popular Pharmacy program. Diabetes prevalence in Brazil was 9.2%, according to the multinomial model, and prevalence in the corrected PNS (self-report + altered glycated hemoglobin - HbA1c > /= 6.5) was 9.4%. The proportion of diabetes mellitus underreporting in the country was 42.5%, reaching 72.8% in the North. Among individuals diagnosed with diabetes mellitus, half presented HbA1c > /= 6.5. Insufficient fundus eye examination (only 40% on average), with major regional variation (North 25% - Southeast 52%), is reflected in the high prevalence of retinopathy. Insufficient examination of feet (only 30%), can lead to more amputations. About 80% of diabetics used medications, indicating a persistently high proportion still without treatment. Healthcare deficiencies for diabetics lead to greater morbidity, hospitalizations (15%), and visits to emergency departments (27%, PMAQ). The scenario in 2012, although not ideal, occurred in a context of strengthening of the Brazilian Unified National Health System (SUS). The growing prevalence of diabetes mellitus and cutbacks in public health budgeting call for serious reflection on control of the disease in the coming years.
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