Objectives: Therapeutic options of pancreatic neuroendocrine neoplasia (Pan-NEN) have increased over the last decade. We aim to understand the evolution of the prognosis of patients with diagnosis of pancreatic neuroendocrine neoplasia within a 12 year-period, considering the implementation of new treatments. Methods: Retrospective cohort study of patients diagnosed with Pan-NENs between 2006 and 2017. Survival outcomes estimates were calculated by Kaplan-Meier method. The impact of baseline clinicopathological characteristics on survival was explored with the use of Cox proportional hazard model. Results: Of the 97 patients, 77 (79.9%) were well differentiated neuroendocrine tumor (NET) – WHO 2010 classification, and 52 (53.6%) had localized or locoregional disease. There were no differences between clinicopathological characteristics and in survival outcomes when comparing patients diagnosed between 2006-2011 and 2012-2017. Neuroendocrine carcinoma – HR 2.76 95%CI 1.17-6.55 – and stage III and IV were independent poor-prognostic factors – HR 6.02 95%CI 2.22-16.33 and HR 6.93 95%CI 2.94-16.32, respectively. Conclusions: The new therapeutic approaches did not induce better survival outcomes on Pan-NEN in recent years. This is possibly due to the indolent nature of NET grade 1 and 2, even metastatic, allowing patients to be submitted to new target therapies along their disease course.

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RESUMO Trata-se de relato crítico-reflexivo sobre a experiência de disciplina optativa voltada à formação de profissionais da saúde no combate ao racismo, oferecida aos estudantes de graduação da área de saúde na Universidade de São Paulo, durante a pandemia de Covid-19. A partir da descrição e da reflexão sobre as atividades de ensino e avaliação propostas, buscou-se reconhecer e apre(e)nder a contribuição da integração de saberes (interdisciplinaridade), de profissões (interprofissionalidade) e da diversidade racial no processo ensino-aprendizagem voltado ao combate ao racismo. São relatadas perspectivas de discentes, monitoras e docentes. A oferta da disciplina, com apoio de convidados, permitiu que o projeto abordasse o racismo e suas influências na saúde das pessoas negras e estimulou a produção cultural dos estudantes. A iniciativa mostrou-se uma possibilidade de introduzir mudanças na formação dos futuros profissionais de saúde em prol tanto da integralidade do cuidado quanto da colaboração interprofissional no combate ao racismo.

Thirteen years after the publication of the National Policy for the Comprehensive Health of the Black Population (PNSIPN, Política Nacional da Saúde Integral da População Negra), filling out the race/skin color question in the patient identification form remains a challenge. Authors have focused on the need to integrate knowledge from the science of implementation into public policies. The aim of this article is to describe and analyze the implementation of the collection of the race/skin color item carried out by the professionals responsible for the registration of patients at a university hospital in the city of São Paulo. This was an exploratory and descriptive study, structured from three constructs of the Consolidated Framework for Implementation Research (CFIR): intervention, internal scenario and characteristics of individuals. Most records of race/ skin color in the observed institution are made by heteroidentification. Based on the CFIR constructs, aspects identified as obstacles and facilitators are identified. The implementation of the collection of the race/skin color item by self-declaration, as provided for in the PNSIPN and in Ordinance n. 344/2017, is still incipient and depends mainly on organizational changes, which can favor its effectiveness.

Resumo Após 13 anos da publicação da Política Nacional da Saúde Integral da População Negra (PNSIPN), o preenchimento do quesito raça/cor na identificação de pacientes permanece um desafio. Autores têm se debruçado sobre a necessidade de integrar os conhecimentos da ciência da implementação às políticas públicas. O objetivo deste artigo é descrever e analisar a implementação da coleta do quesito raça/cor feito pelos profissionais responsáveis pelo registro dos pacientes num hospital universitário do município de São Paulo. Estudo exploratório e descritivo, estruturado a partir de três constructos do Consolidated Framework for Implementation Research (CFIR): intervenção, cenário interno e características dos indivíduos. Resultados: a maioria dos registros do quesito raça/cor na instituição observada é feita por heteroidentificação. A partir dos constructos do CFIR, são identificados aspectos apontados como obstáculos ou facilitadores. A implementação da coleta do quesito raça/cor por autodeclaração, como previsto na PNSIPN e na Portaria 344/2017, ainda é incipiente e depende de mudanças, sobretudo organizacionais, que favoreçam sua efetivação. Palavras-chave Quesito raça/cor,

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This is a critical-reflective report on the experience of an elective course aimed at training health professionals in fighting racism. It was offered during the COVID-19 pandemic to undergraduate students from all the health subspecialties at the University of São Paulo. From the description and reflection on the proposed teaching and evaluation activities, we sought to recognize and learn/apprehend the contribution of the integration of knowledge (interdisciplinarity), professions (interprofessionality), and racial diversity in the teaching-learning process aimed at fighting racism. The perspectives of students, monitors, and teachers are reported. The support of guest teachers allowed this initiative to address racism and its influences on the health of black people, and the educational strategies encouraged students’ cultural production. The initiative proved to be a possibility for introducing changes in health education in favor of both comprehensive care and interprofessional collaboration in dismantling racism.