Em meio à crescente cultura do uso abusivo e indiscriminado de exames, procedimentos e tratamentos, surgiu a iniciativa Choosing Wisely ("escolhendo com sabedoria" em tradução literal), a qual tem o intuito de evitar a realização de condutas desnecessárias
RESUMOErros de prescrições são situações evitáveis que podem ser identificadas e corrigidas por meio de avaliação da qualidade das receitas e acompanhamento na compreensão do paciente. O preenchimento inadequado pode gerar danos ao paciente e tornar o tratamento ineficaz e prejudicial. Portanto, o presente estudo objetiva revisar a literatura para
Erros de prescrições são situações evitáveis que podem ser identificadas e corrigidas por meio de avaliação da qualidade das receitas e acompanhamento na compreensão do paciente. O preenchimento inadequado pode gerar danos ao paciente e tornar o tratamento ineficaz e prejudicial. Portanto, o presente estudo objetiva revisar a literatura para descrever os principais erros das prescrições médicas e o entendimento do paciente nas unidades de saúde acerca das receitas, além de como os equívocos podem afetar o tratamento. Estudos descritivos revisados apontaram que 74% dos entrevistados não possuíam informações suficientes sobre o objetivo do tratamento terapêutico e 34,66% das prescrições estavam pouco legíveis. Dessa forma, é imperativo que os profissionais da saúde estejam atentos ao entendimento do paciente quanto às instruções fornecidas, de forma a melhorar a relação médico-paciente e evitar transtornos para o usuário do sistema de saúde.
Objective: To analyze the overall survival of women with breast cancer based on clinical, histological, and biological tumor data in a secondary hospital in Federal District/Brazil. Method: Retrospective cohort study of women diagnosed with breast cancer from 2012 to 2019, followed up until December 2020, having its data analyzed in 2021. The population studied was from the area covered of the Regional Hospital of Santa Maria (Brasília/Distrito Federal/Brazil), a secondary service, linked to the Brazilian Unified Health System. The information analyzed in this study were state at the last visit (life or dead), the presence of clinically compromised axillary lymph nodes, staging by the TNM system, location of distant metastasis (bone or visceral), histological type and grade, and tumor biological profile. Subsequently, survivals were analyzed in relation to variables previously described. The data were analyzed with the aid of the statistical package SPSS (version 26.0), with p<0.05 is considered significant. Results: This study included a total of 203 patients, of which 158 (77.8%) survived and 45 (22.2%) died. Regarding deaths, 67.5% had a clinically compromised armpit (p<0.001) and 50% were in stage IV (p<0.001). In relation to overall survival, worse survival was observed for patients with clinically suspect lymph nodes (p<0.001), for tumors measuring between 2 and 5 cm and tumors larger than 5 cm in relation to tumors smaller than 2 cm (p<0.001), and for stages III and IV compared to stages I and II (p<0.001). There was no worsening of survival in relation to the histological type (p=0.39), histological grade (p=0.65), location of metastases (bone and visceral) (p=0.76), or biological profile (p=0.40). Conclusion: There were more deaths in relation to the clinically compromised axillary state and in stages III and IV. Larger tumors, more advanced staging, and a clinically compromised armpit worsened overall survival.
Objective: To evaluate treatments performed in women with malignant breast cancer treated at the mastology service of a public secondary-level hospital. Method: A cross-sectional study with women diagnosed with breast cancer from 2012 to 2019. Treatments evaluated were surgery, chemotherapy, radiotherapy, and hormone therapy. Data were analyzed using the SPSS software (vision 26.0), considering p<0.05 as significant. Results: We evaluated the data of 227 patients with tumors in stages I (10.1%), II (35.2%), III (26.9%), and IV (12.78%), with 55.5% of them between the ages of 40 and 60 years. Mastectomy was performed in 61.7% of the patients, with 84.6% not undergoing immediate reconstruction, while 12.8% undergoing late reconstruction. Techniques used were large dorsal muscle flap with prosthesis (29.4%), rectus abdominis muscle (26.5%), and only prosthesis (23.5%). Patients aged <0.001). Radiotherapy was performed in 56.8% of the patients, with those aged <40 years found significant (p=0.005). Hormone therapy was performed in 59.0% of the patients. The mean time between diagnosis and the start of chemotherapy was 134.8±126.5 days, and the average gap between treatments (chemotherapy/radiotherapy) was 188.2±204.6 days. Conclusion: Mastectomy was the most performed treatment, with a small part of the patients obtaining breast reconstruction. Most patients needed some type of complementary therapy, especially the younger ones. The average time between diagnosis and treatment was longer than that recommended by current legislation. Awareness measures and better access to women with breast complaints should be emphasized, especially in younger women.
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