Purpose To evaluate the emotional, psychological, sexual, social, and professional impact, before and after surgery, on individuals submitted to a colostomy. Methods The study was carried out in two stages, with the participation of 15 individuals. First, we evaluated the emotional, psychic, sexual, social, and professional aspects of their lives, in the preoperative period of colostomy surgery. After that, the same aspects were evaluated six months after the surgery. This evaluation was based on the application of a questionnaire with 16 objective questions. Results Of the interviewees, 53.64% decreased their willingness to go out and do activities outside their homes, with a statistical significance of p = 0.001. Regarding the environment, 53.85% of the interviewees showed a perception of worsening of the environment. About physical activity, 66.65% showed a difference in the performance of physical activity after colostomy, being statistically significant, with p = 0.001. The sports environment did not change in 50% of the participants. Patient sexuality showed a significant decline with statistical significance (p = 0.008). Conclusion The impact that the colostomy generated on the patients’ lives, regarding the evaluated aspects, was perceptible, being of great importance the careful indication of this procedure to the patient.

Resumo Violência doméstica é o tipo mais comum de violência contra a mulher e resulta em sequelas nas esferas física, emocional, familiar e econômica, constituindo problema de saúde pública. Porém, a questão é tratada de maneira negligente pelos profissionais de saúde, o que contribui para sua invisibilidade. Baseado em revisão da literatura, este estudo objetivou identificar as principais dificuldades, incluindo conflitos éticos, encontradas pelos médicos na abordagem de pacientes vítimas desse tipo de violência. Os obstáculos elementares foram agrupados em três grandes eixos: questões relacionadas ao profissional de saúde; estrutura do sistema de saúde; e aspectos das vítimas de violência. Concluiu-se que o maior entrave advém do próprio profissional de saúde e envolve fatores que variam desde formação inadequada até a ocorrência de conflitos morais e éticos que culminam na culpabilização e responsabilização das vítimas pela situação de violência em que se encontram.

<b><i>Background:</i></b> A malignant pleural effusion (MPE) in patients with cancer is evidence of the underlying disease progression, resulting in many symptoms, and may lead to hospitalization. The treatment options include talc pleurodesis (TP) or the implantation of an indwelling pleural catheter. The costs of the latter approach are often seen to be inhibitive for the Brazilian and other emerging markets’ public health system. <b><i>Objectives:</i></b> To assess the feasibility of utilizing a low-cost device (LunGO) through a case-control study. <b><i>Methods:</i></b> Eighteen patients with recurrent neoplastic pleural effusion and contraindications to pleurodesis were recruited between June 2016 and November 2017. The patients were submitted to pleural catheter prototype implantation. Data on the underlying disease and hospital length of stay after the procedure were collected and compared with patients who underwent pleurodesis in the same period (control group, <i>n</i> = 34). <b><i>Results:</i></b> In the LunGO group, 7 patients died due to the natural evolution of the underlying disease with the drain, whereas it was removed in 11 patients at a median of 43 days. Recurrence requiring an intervention was seen with the LunGO in 2, compared to 5 (OR = 1.37, <i>p</i> = 1) with TP. Complications were observed in only 1 with the LunGO, compared to 5 with TP. The chances of recurrence in both cohorts do not have a statistically significant difference, with an OR = 1.08 (<i>p</i> = 0.93). There was a tendency towards lower mortality in the LunGO cohort, despite that fact that we did not observe statistical significance (OR = 0.16, <i>p</i> = 0.23). <b><i>Conclusion:</i></b> LunGO was shown to be a viable and safe device for the treatment of symptomatic MPE.

Older people's knowledge about and access to the geriatrics service of Mogi das Cruzes, São Paulo Conocimiento y acceso de mayores a los servicios de geriatría de Mogi das Cruzes/SP RESUMO Objetivo: Avaliar o conhecimento e o acesso de idosos ao serviço de geriatria de uma policlínica localizada em Mogi das Cruzes, SP. Métodos: Participaram 200 idosos que aguardavam uma consulta ambulatorial na sala de espera da Policlínica da Universidade de Mogi das Cruzes. Esses idosos responderam a um questionário no período de setembro de 2013 a janeiro de 2014. Resultados: Dos avaliados, 58% (n=116) dos participantes afirmaram saber da existência do médico geriatra, porém, apenas 9,5% (n=19) foram atendidos por esse especialista. Quanto aos idosos que costumam passar apenas por uma única especialidade para consultas rotineiras, 8% (n=16) buscam especialidades diferentes das de clínico geral, cardiologista e ginecologista. Dentre essas outras especialidades, apenas 17,6% (n=35) buscam o geriatra. A maioria dos participantes, 99,5% (n=199), considera importante que o idoso passe por um médico geriatra. Conclusão: A maioria dos idosos indagados conhece a especialidade geriátrica, porém nunca tiveram a oportunidade de se consultar com um médico geriatra, embora reconheçam que isso devesse ocorrer. Apesar da existência desta especialidade na policlínica, pode-se dizer que a população não está informada sobre a disponibilidade dos atendimentos desse profissional no serviço municipal.