Sex steroids have been widely described to be associated with a number of human diseases, including hormone-dependent tumors. Several studies have been concerned about the factors regulating the availability of sex steroids and its importance in the pathophysiological aspects of the reproductive cancers in women. In premenopausal women, large fluctuations in the concentration of circulating estradiol (E2) and progesterone (P4) orchestrate many events across the menstrual cycle. After menopause, the levels of circulating E2 and P4 decline but remain at high concentration in the peripheral tissues. Notably, there is a strong relationship between circulating sex hormones and female reproductive cancers (e.g. ovarian, breast, and endometrial cancers). These hormones activate a number of specific signaling pathways after binding either to estrogen receptors (ERs), especially ERα, ERα36, and ERβ or progesterone receptors (PRs). Importantly, the course of the disease will depend on particular transactivation pathway. Identifying ER- or PR-positive tumors will benefit patients in terms of proper endocrine therapy. Based on hormonal responsiveness, effective prevention methods for ovarian, breast, and endometrial cancers represent a special opportunity for women at risk of malignancies. Hormone replacement therapy (HRT) might significantly increase the risk of these cancer types, and endocrine treatments targeting ER signaling may be helpful against E2-dependent tumors. This review will present the role of sex steroids and their receptors associated with the risk of developing female reproductive cancers, with emphasis on E2 levels in pre and postmenopausal women. In addition, new therapeutic strategies for improving the survival rate outcomes in women will be addressed.

SUMMARYIntroduction:Group B streptococcus (GBS) or Streptococcus agalactiae can colonize the gastrointestinal and genitourinary tracts and has been considered one of the most important risk factors for the development of neonatal disease. The present study evaluated the antimicrobial susceptibility of GBS isolates from pregnant women who were attended at a public health service in Northern Paraná, Brazil. Methods:A descriptive analytical cross-sectional study was performed with 544 pregnant women, at ≥ 35 weeks of gestation. One hundred and thirty-six GBS isolates from pregnant women were tested for antimicrobial susceptibility. Results:All of the GBS isolates showed susceptibility to the drug that is most frequently used for intrapartum prophylaxis: penicillin. Resistance to clindamycin and erythromycin was detected, thus decreasing the options of prophylaxis in women who are allergic to penicillin. Conclusions: Additional studies should be conducted to increase the knowledge of GBS sensitivity profile to antimicrobials in other health centers.

Introduction The aim of this study was to determine the prevalence of GBS colonization in pregnant women in a public health service.Methods A study of 496 pregnant women at 35-37 gestational weeks was conducted from September 2011 to March 2014 in 21 municipalities of the 18th Health Region of Paraná State. Vaginal and anorectal samples of each woman were plated on sheep blood agar, and in HPTH and Todd-Hewitt enrichment broths.Results Of the 496 pregnant women, 141 (28.4%) were positive for GBS based on the combination of the three culture media with vaginal and anorectal samples. The prevalence was 23.7% for vaginal samples and 21.9% for anorectal ones. Among the variables analyzed in this study, only urinary infection was a significant factor (0.026) associated with GBS colonization in women.Conclusions Based on these results, health units should performs universal screening of pregnant women and hospitals should provide adequate prophylaxis, when indicated.

Objetivo: analisar o conhecimento dos profissionais de escolas municipais após a prática educativa de atendimento de primeiros socorros na infância. Método: estudo quase‑experimental, quantitativo. Para a coleta de dados, utilizou-se um questionário sobre primeiros socorros na infância, aplicado antes e após uma prática educativa com 88 profissionais. Na análise dos dados, adotou-se o percentual de acertos para cada questão e a média percentual de acertos total. Aplicaram-se os testes McNemar e Wilcoxon. Resultados: após a prática educativa, houve aumento significativo no percentual de acertos em seis questões, redução do acerto em uma questão; e não alteração em duas questões, totalizando em 30% o acréscimo da retenção de conhecimento. Conclusão: o nível de conhecimento prévio dos profissionais sobre primeiros socorros foi relativamente baixo, entretanto observou-se uma apreensão de conhecimento significativo após a prática educativa, que poderá contribuir para o atendimento inicial de qualidade à vítima.

Objectives: to estimate the prevalence of drug abuse in pregnant women and to associate with the variables education, family income, race and number of pregnancies. Methods: descriptive, cross-sectional, quantitative research. Developed in the municipality of Bandeirantes-PR, from June 2016 to December 2017. The population was 114 pregnant women and the dependent variables were alcohol / tobacco use and illicit drugs and the independent variables were education, race, family income and number of pregnancies. The analysis was the comparison between the variables and Microsoft Excel 2007 and SPSS 20.0 was used. It was approved by the Ethics Committee. Results: the use of drugs of abuse during pregnancy was 19.2%, presenting as a sociodemographic profile characterization the age between 19 to 29 years, predominance of nonwhite race, with study time ≤ 9 years, with income from 1 to 2 minimum wages and multiparous women. The most commonly used drug of abuse was alcohol, followed by tobacco. Concomitant use between drugs was significant with alcohol and tobacco / illicit drugs and tobacco. Conclusions: drug use had a prevalence of 19.2% and acts in conjunction with social issues and this case, intervening is necessary with an individualized care plan, thus ensuring the promotion and prevention of maternal and child health.

Objetivo: verificar sintomas depressivos em gestantes adolescentes em unidade básica de saúde. Métodos: Cinquenta e cinco adolescentes grávidas foram entrevistadas na unidade de saúde. Para a coleta de dados, foram utilizados dois instrumentos: um para dados sociais, demográficos, obstétricos, relações familiares e eventos de violência, e outro para avaliar os sintomas depressivos - Inventário de Depressão de Beck. Resultados: 10,9% das entrevistadas tinham história prévia de depressão ou ansiedade e 3,6% apresentavam um desses problemas no momento da entrevista. 63,6% das adolescentes relataram ter sofrido algum evento estressante no último ano. 49,1% das adolescentes grávidas apresentam sintomas depressivos variando entre leve, moderado e grave. Conclusões: é essencial identificar os primeiros sintomas depressivos em gestantes, para que elas sejam encaminhadas ao serviço especializado, ou detectar a presença de uma equipe de saúde mental em um centro de saúde, para prestar um tratamento adequado e um cuidado de qualidade e humanizado.

A esquistossomose é uma das principais doenças parasitárias do mundo devido a sua prevalência e consequências econômicas na saúde pública nos locais onde ocorre. As estimativas apontam que 779 milhões de pessoas estão sob risco de infecção e 243 milhões de pessoas necessitaram de tratamento em 2011. No Brasil, a esquistossomose tem sido notificada em Estados do Nordeste, Sudeste e Sul, acometendo aproximadamente seis milhões de indivíduos. No Estado do Paraná se verifica a disseminação de moluscos da família Planorbidae em 102 municípios. O objetivo foi verificar a situação de transmissão da esquistossomose em área urbana do município de Bandeirantes, Paraná. Tratase de um estudo de caráter epidemiológico descritivo, de corte transversal, realizado em duas etapas. Na primeira etapa foi feito um estudo retrospectivo dos casos da doença e, na segunda, foi feita a aplicação de questionário sobre o comportamento das pessoas e das condições sanitárias e ambientais da Vila São Pedro. Nesta etapa, as fezes de 301 habitantes desta vila foram coletadas e examinadas pelo método de Kato-Katz. Constatou-se somente nove (2,99%) indivíduos infectados por Schistosoma mansoni, dos quais dois foram classificados com o grau moderado/alto de infecção. Os resultados mostram que houve redução de casos de esquistossomose no município de Bandeirantes.Palavras-chave: Schistosoma mansoni. Epidemiologia. Saúde Pública.AbstractSchistosomiasis is one of the world’s major parasitic diseases due to its prevalence and economic consequences in public health where it occurs. Estimates indicate that 779 million people are at risk of infection and 243 million people needed treatment in 2011. In Brazil, schistosomiasis has been reported in northeastern, southeastern and southern states, affecting approximately six million individuals. In the state of Paraná the dissemination of mollusks of the Planorbidae family is found in 102 municipalities. The objective was to verify the status of transmission of schistosomiasis in an urban area of the city of Bandeirantes, Paraná. It is a descriptive epidemiological study ofcross-sectional character, carried out in two stages. In the first stage a retrospective study was done of cases of the disease and in the second a questionnaire was done on the individuals’ behavior, sanitary and environmental conditions of Vila São Pedro. At this stage the feces of 301 inhabitants of this village were collected and examined by the Kato-Katz. It was found only nine (2.99%) individuals infected with Schistosoma mansoni, of which two were classified as moderate / high level of infection. The results showed a significant reduction of schistosomiasis cases in the city of Bandeirantes.Keywords: Infection. Schistosoma mansoni. Epidemiology. Public Health.

Objective To know the institutionalization process and the functional clinical condition of elderly people who suffered family violence, from the perspective of the elderly and professionals. Methods Qualitative, which used oral history as a data collection technique. Held in a long-term institution for the elderly, using a semi-structured interview script. The participants were three nursing technicians, two nursing assistants, five caregivers for the elderly and eight elderly. Thematic analysis was performed with the aid of the MAXQDA® software. Results Three categories were identified: The condition of vulnerability and the care needs of the elderly, indicating welcoming as an intervention; Suffering and denial of conditions of vulnerability; and Situations of family violence and the positive aspects of reception. Conclusions Long-term institutions are considered important spaces for comprehensive and humanized care, as well as essential for the protection of elderly victims of family violence.