Objectives: This study was conducted aiming to assess the quality of life and satisfaction of women who had mastectomy treated with and without breast reconstruction. Results: A total of 81 women who had mastectomy were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of women who had mastectomy who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life.

There have been arguments about the role of breast cancer screening at the population level, and some points of controversy have arisen, such the establishment of organized screening policies and the age at which to begin screening. The real benefit of screening has been questioned because the results of this practice may increase the diagnosis of indolent lesions without decreasing mortality due to breast cancer. The authors have proposed a study of incidence and mortality trends for breast cancer in a developing setting in Brazil to monitor the effectiveness of the official recommendations that prioritize the age group from 50 to 69 years. The database of the Cancer Registry and the Mortality Information System was used to calculate age-standardized and age-specific rates, which were then used to calculate incidence and mortality trends using the Joinpoint Regression Program. The results showed stability in trends across all ages and age-specific groups in both incidence and mortality. In conclusion, we found that incidence and mortality rates are compatible with those in regions with similar human development indexes, and trends have demonstrated stabilization. Thus, we do not endorse changes in the official recommendations to conduct screening for ages other than 50 to 69 years, nor should policy makers implement organized screening strategies. Considering the epidemiological transition of developing countries, breast cancer has become a growing burden in these areas 1. Brazil has been experiencing increasing incidence rates, especially in state capitals and more developed regions 2. Mortality rates have also remained high 3. Breast cancer is the type of cancer with the highest mortality rate among women. Brazilian cancer registries cover less than 50% of the Brazilian population, and incidence rates are obtained by estimates made by the Brazilian National Cancer Institute (INCA) every two years. It has been estimated that the mean age-standardized incidence rate for 2018-2019 in Brazil is 51.3 per 100,000 women; in the state capitals, the estimated rate is 64.0 per 100,000 women 4. Information regarding the impact of mortality comes from the analysis of the database of the Mortality Information System (SIM). For 2016, the age-standardized mortality rate in Brazil was 12.7 per 100,000 women 5. The role of screening has been discussed, including whether it has actually been effective in decreasing mortality and not just increasing survival and whether the difference is due only to the overdiagnosis of approximately 30% additional cases obtained by screening mammography 6-8. A major point of argument regarding screening has been the age at which to start. Many organizations associated with cancer control have advocated starting screening at the age of 40 years, emphasizing the associated increase in survival. However, we must consider the possibility of diagnosing indolent lesions, which inflates the incidence statistics and leads to consequent overtreatment that could be harmful to the patient 9-11 .

RESUMO: A doença inflamatória intestinal idiopática (DII) representa um grupo de condições inflamatórias crônicas, resultantes de ativação persistente e inadequada do sistema imune mucoso. Além dos sintomas intestinais característicos, as DII podem se manifestar através de uma série de manifestações extraintestinais (MEI). Objetivos: Avaliar a incidência das MEI das doenças inflamatórias intestinais no Hospital Universitário da INTRODUÇÃOA doença inflamatória intestinal idiopática (DII), representada pela doença de Crohn e pela retocolite ulcerativa, é um grupo de condições inflamatórias crônicas, resultantes de ativação persistente e inadequada do sistema imune mucoso. Essa desregulação do sistema imune manifesta-se através de uma elevação local de diversas citocinas, como TNFalfa, interferon-gama, IL-12, IL-13 e IL-171 . A etiologia dessas patologias ainda não foi definitivamente esclarecida 2,3 . DII constitue-se em um problema de saúde pública em muitos países. Importantes trabalhos retrospectivos sobre a epidemiologia da DII realizados, sobretudo, a partir de 1980, demonstraram que está havendo uma tendência mundial para o aumento da sua incidência [4][5][6][7][8] . Sua incidência tem aumentado nos países desenvolvidos, girando em torno de 50 a 70 casos/1.000.000 por ano 9 , e há evidente tendência de crescimento da incidência nos países em desenvolvimento como ocorre na Amé-rica do Sul 10,11 . Além dos sintomas intestinais característicos (como diarreia, sangue e muco nas fezes, tenesmo retal), as DII podem se manifestar através de uma série de manifestações extraintestinais (MEI) que podem passar despercebidas. Entre essas, pode-se citar: articulares, como artralgia e espondilite anquilosante; dermatológicas, como eritema nodoso e psoríase; oftalmológicas, como uveíte e episclerite; urológicas, como litíase renal, insuficiência renal e nefroesclerose; hepatobiliares, como colelitíase, esteatose e colangite esclerosante; pulmonares, como derrame pleural, broquiectasia e asma; e manifestações vasculares, como trombose venosa e vasculites 5 . Atualmente, temos ambulatório de referência em DII no Hospital Universitário da Universidade Federal de Sergipe (HU/UFS), com um número significativo de pacientes. É importante ressaltar a escassez de dados epidemiológicos acerca dessa patologia, em nosso país, que passa despercebida pelos grandes levantamentos de saúde pública nacional. Dada a falta de informações sobre a ocorrência das DII no Brasil, é essencial que se construa um perfil demográfico e clínico dos pacientes com DII e que se avalie a ocorrência das MEI nos mesmos. OBJETIVOAvaliar a incidência das MEI das DII (retocolite ulceratica idiopática -RCUI -e doença de Crohn -DC), diagnosticando-as e instituindo o tratamento adequado dos pacientes portadores dessas manifestações. MÉTODOS CasuísticaEste trabalho consistiu em um estudo descritivo prospectivo, do tipo coorte longitudinal, onde foram incluídos os pacientes atendidos no ambulatório de referência de DII do Serviço de Coloproctologia do HU/ UFS, no per...

Objectives  To assess the quality of life of patients diagnosed with inflammatory bowel disease (IBD) using immunobiological therapy and to relate the general and domain scores of the Inflammatory Bowel Disease Questionnaire (IBDQ) to the immunobiological drug in use and the clinical and sociodemographic variables. Methods  This was a descriptive observational cross-sectional study, conducted from June to September 2018 in a tertiary hospital in Sergipe, which included 47 patients with a diagnosis of Crohn's disease. The IBDQ questionnaire was applied together with a sociodemographic questionnaire, and the clinical data and the history of the disease were analyzed. Results  Female, mixed-race, married patients from the countryside of the state of Sergipe, Brazil, who had never undergone any intestinal surgery, represented most of the study participants. 24 patients were on infliximab and 23 were on adalimumab. Variables such as gender, type of immunobiological drug and duration of its use, and association of therapy with other medications were shown to statistically significantly influence the report quality of life ( p -value < 0.05). Conclusion  Further studies with larger samples are necessary to allow a more accurate delimitation of the impact of clinical and sociodemographic variables on the quality of life of patients with inflammatory bowel disease.

Objectives This study was conducted to analyze the trends in colorectal cancer (CRC) incidence and mortality in the city of Aracaju, Sergipe State, Brazil, between 1996 and 2015 with Joinpoint Regression Program 4.7.0.0 and to identify the geographical distribution of CRC in the municipality. Results A total of 1322 cases of CRC and 467 CRC-related deaths during the study period were included. In total, 40% of the incident cases and 43% of the deaths occurred in men, while 60% of the incident cases and 57% of the deaths occurred in women. Males who were 20 to 44 years old had the most significant trend in growth. Among women, those in the group aged 45 to 64 years had the highest observed annual percent change (APC). In both sexes, mortality was stable. Regarding the geographic distribution, there were constant hotspots in the northeast region of the municipality. This study showed a significant increase in incidence, mainly in young men between 20 and 44 years of age, but stable mortality in Aracaju.