Acute Hepatitis in Pregnancy: A Case Report

Introduction: Several changes occur in women’s body during pregnancy, as well as several pathologies can arise at this period, such as hepatitis. It is very important to have the correct diagnosis and proper treatment for pregnant women because liver diseases can increase maternal and/or fetal morbidity and mortality rates. Case Report: Patient in the age group 32 years, G2P0A1, thrombophilic, using ASA, enoxaparin, folate, and B-complex, reported jaundice, low fever, and pruritus in the 32nd week of pregnancy. Laboratory exams showed high levels of direct hyperbilirubinemia and aminotransferases, with negative serology results for the most common viruses and autoimmunity markers. Hypervitaminosis B12 was an additional finding; it was canceled. The patient had a satisfactory recovery after support treatment. Discussion: Hepatitis has several etiologies; it is caused by infections, medications, or triggered by the immune system. The main infectious agents causing hepatitis A, B, C, and E; Dengue, Zika, HTLV, cytomegalovirus, toxoplasmosis, rubella, and brucellosis were screened in the reported case – the patient was negative for all of them. Other possible diagnoses, such as acute liver steatosis of pregnancy, portal thrombosis, and autoimmune hepatitis were excluded. Hepatitis caused by medicines was not confirmed because clinical and laboratory exams showed improvement in the patient’s clinical condition even with ASA and enoxaparin administration. The patient had high vitamin B12 level, which can be a liver damage marker. Transaminases and bilirubin showed a progressive decrease after the treatment; both patient and newborn had a satisfactory recovery. The reported condition was caused by a combination of factors, such as pregnancy hormone levels, unidentified infection, and possible predisposition to develop the disease. The patient remains under hematological and hepatological follow up, but there is no record of relapse, so far.</jats:p

Regionalização como estratégia para a definição de políticas públicas de controle de homicídios Regionalization as a strategy for the definition of homicide-control public policies

Neste artigo, analisamos a distribuição espacial das taxas de homicídios no Estado de Minas Gerais, Brasil, utilizando dados do Sistema de Informações de Mortalidade do Ministério da Saúde (SIM-MS), no período de 1996 a 2000. Os dados populacionais utilizados para o cálculo das taxas também foram obtidos através do MS. Diante da grande extensão territorial do Estado, utilizamos uma metodologia estatística desenvolvida recentemente, implementada no programa SKATER, para a geração de conglomerados espaciais homogêneos. Como resultado, obtivemos 24 conglomerados espaciais, nos quais os municípios semelhantes em relação às taxas de homicídios ficaram agrupados. A partir desses resultados, discutimos a possibilidade da criação de "Núcleos de Gerenciamento em Segurança Pública", que permitiriam a implementação de políticas públicas voltadas para o controle e a diminuição de homicídios em cidades com características semelhantes no que diz respeito a esse tipo de crime.<br>This article analyzes the spatial distribution of homicide rates in Minas Gerais State, Brazil, using data from the Ministry of Health Mortality Information System (SIM/MS) from 1996 to 2000. Population data used to calculate rates were also obtained from the Brazilian Ministry of Health. Minas Gerais has a large territory, so the study used a recently developed statistical methodology implemented in the SKATER software to generate homogeneous spatial clusters. The technique obtained 24 spatial clusters, in which municipalities with similar homicide rates were aggregated. Using these results, the authors discuss the possible creation of "public security administration areas" that would allow the implementation of public policies aimed at controlling and diminishing homicides in municipalities with similar characteristics for this type of crime