Introdução: O câncer do colo do útero apresenta-se como importante problema de saúde pública mundial, principalmente nas regiões menos desenvolvidas. Objetivo: Descrever os perfis sociodemográfico e clínico das mulheres com câncer do colo do útero atendidas no Hospital Santa Rita de Cássia/Associacao Feminina de Educação e Combate ao Câncer (HSRC /AFECC) entre 2000 e 2005, associados ao estadiamento inicial. Método: Trata-se de um estudo analítico de dados secundários. Foram estudadas 964 mulheres. Resultados: Houve predominância de casos na faixa etária de 40 a 59 anos (49,3%), cor não branca (76,8%), com até primeiro grau incompleto (70,9%), casadas (48.3%), com encaminhamento do Sistema Único de Saúde (SUS) (84,2%). O estadiamento III esteve presente em 44% dos casos, seguido do II (31,4%). A maioria das pacientes realizou radioterapia exclusiva (52,1%), 133 (28,2%) tiveram recidiva local e 218 (43,4%) metástases a distância. As variáveis significantes com o estadiamento inicial foram faixa etária, escolaridade, tipo histológico, recidiva, presença de metástase, número de metástases e desfecho (p<0,05). Conclusão: Os resultados apontam para a necessidade de novas estratégias na implementação das políticas de saúde no que diz respeito a prevenção primária e secundária, tendo em vista o grande número de mulheres diagnosticadas com a doença. Maiores investimentos em educação também são necessários visando a uma mudança no perfil de morbimortalidade da doença.
Resumo Disparidades na atenção ao câncer de próstata têm sido reveladas e associadas a fatores sociodemográficos e clínicos, os quais determinam os tempos para diagnóstico e início do tratamento. O objetivo deste artigo é avaliar a associação de variáveis sociodemográficas e clínicas com os tempos para o início do tratamento do câncer de próstata. Estudo de coorte longitudinal prospectivo utilizando dados secundários, cuja população é de homens com câncer de próstata atendidos nos períodos de 2010-2011 e 2013-2014 no Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brasil. A população do estudo foi de 1.388 homens, do total, os com idade inferior a 70 anos (OR = 1,85; IC = 1,49-2,31), não brancos (OR = 1,30; IC = 1,00-1,70), com menos de oito anos de estudo (OR = 1,52; IC = 1,06-2,17) e encaminhados pelos serviços do Sistema Único de Saúde (OR = 2,52; IC = 1,84-3,46) apresentaram maior risco de atraso no tratamento. Da mesma forma, quanto menor o escore de Gleason (OR = 1,78; IC = 1,37-2,32) e os níveis de Antígeno Prostático Específico (OR = 2,71; IC = 2,07-3,54) maior a probabilidade de atraso para iniciar o tratamento. Portanto, as características sociodemográficas e clínicas exerceram uma forte influência no acesso ao tratamento do câncer de próstata.
Objetivo: Avaliar a associação de variáveis sociodemográficas e clínicas com a mortalidade geral e específica por câncer de próstata. Método: Estudo retrospectivo de 1290 homens diagnosticados com câncer de próstata entre 2000 e 2006. Consultou-se prontuários, Sistema de Registro Hospitalar e Sistema de Informações sobre Mortalidade. Resultados: Dos 1290 homens, 758 estavam vivos, 308 morreram por câncer de próstata e 224 por outras causas. Associaram-se ao óbito por câncer de próstata: escore de Gleason > 9, PSA > 20 (entre 2,82 e 5,55 vezes) e presença de metástase. Associaram-se ao óbito por outras causas: estado civil viúvo, ingresso no hospital sem diagnóstico e sem tratamento e PSA > 50. Conclusão: Variáveis clínicas predominaram sobre a mortalidade específica por câncer de próstata, já variáveis sociodemográficas em óbitos por outras causas.Descritores: Neoplasias da próstata, Mortalidade, Saúde do homem, Políticas públicas.
This article aims to estimate the specific survival of patients with penile cancer treated at a state tertiary oncology hospital. The study included 100 cases incidents patients with penile cancer treated at a cancer center, from 2000 to 2011, follow-up to December 31, 2012. The hospital-based cancer registry and medical records were used as data sources. We used the Kaplan-Meier method to estimate survival and the Cox model was used to assess prognostic factors. All had histology for penile cancer as a basis for diagnosis. For location of the 75% tumor were not specified, followed by 18% located in the glans, 04% in the foreskin. The median survival time was 49 months, 89% presented themselves between stages I and II. Patients with rural occupations had a mean survival time of 75.02 months, patients with non-rural occupations 42.14 months; Patients residing in metropolitan area - Espírito Santo had a mean survival time of 26.03 months, other patients 71.42 months; In patients with compromised lymph nodes, the mean survival time was 30.59 months, and in patients with no compromised lymph nodes, the mean survival time was 75.83 months. This study demonstrates reduced survival in non-rural workers who reside in metropolitan area and who present with compromised lymph nodes and metastasis.
This study aimed to investigate the association between mortality of breast cancer women and the social-demographic and clinical characteristics. During the mortality study of 1,086 women diagnosed with breast cancer and treated from 2000 to 2005 at a cancer hospital in the city of Vitória, Espírito Santo, medical records and tumor registration cards were controlled. The Mortality Information System and the Reclink program were used to identify 280 deaths. Patients were classified under death and non-death, and variables percentages were calculated. For variables that showed statistical significance, considering the level of 0.10, the crude and adjusted odds ratio (OR) were calculated by logistic regression model. There was a correlation between mortality and the following variables: women coming from the Unified Health System (p = 0.014; OR = 2.38), negative c-erb B-2 tumor marker (p = 0.027; OR = 2.03), advanced (III and IV) staging (p = 0.001; OR = 6.89 and OR = 17.13, respectively), presence of metastasis (p = 0.001; OR = 18.23) and recurrence (p = 0.010; OR = 3.53). Mortality associated with staging underlines the necessity of warning the population about the benefits of early diagnosis of the disease of cancer. IntroductionCancer has proven to be an increasing occurrence and presents high mortality rates, constituting a public health problem 1 . It has been estimated that, in 2008, 7.6 billion deaths were caused by the disease 2 . In Brazil, approximately 518,510 new cases of cancer have been estimated for 2012 and, in 2008, the disease was the second leading cause of death in the country 3,4 . For 2012, of the 260,640 new female cancer cases, it is expected that 53,000 correspond to breast cancer. This makes breast cancer the second most common body location of the disease (the first one being non-melanoma skin tumors) 4 . In southeastern Brazil, authors highlight trends of increased mortality in metropolitan areas 5,6 . In a study conducted in the state of Espírito Santo, in which data from the Mortality Information System from 1980 to 2007 was analyzed, a trend of increased mortality due to breast cancer was identified in all age groups from 30 years on 7 . Along with the INCA (Brazilian Cancer Institute) estimates for the year 2012 -in which the state capital, Vitória, proved to be the eighth Brazilian capital with the highest gross incidence rate of breast cancer (71.28 per 100 thousand inhabitants) -this information indicates the need for studies that characterize the prevalence of the disease 4 . Data related to mortality are of utmost importance, as they allow the description of the disease's magnitude and impact. In addition, study of this data is important to identify gaps in patient access to health services and to indicate improvements in their treatment. Therefore, this study was aimed at the investigation of the association between mortality among women diagnosed with breast cancer between 2000 and 2005, who received treatment at Santa Rita de Cássia Hospital, and its sociodemographi...
Objective: to analyze the factors associated with the human papillomavirus as related to cervical cancer. Methods: cross-sectional study carried out using secondary data from 75 medical records. The chi-squared and Fisher’s exact tests were used, considering papillomavirus infections as an outcome. Odds ratio were used to measure the effect, and the level of significance adopted was 5%. Results: the characteristics associated to the infection by the papillomavirus were: being 24 years old or younger (odds ratio=19.11; p=0.001), having finished high school or higher education (odds ratio=4.06; p=0.031), having multiple sex partners (odds ratio=5.50; p=0.028), and having not gone through menopause (p=0.009). Conclusion: sexual behavior and socioeconomic issues are related to cervical cancer as associated with the papillomavirus infection.
Introdução: O câncer de mama é o segundo tumor de maior incidencia e mortalidade na populacao feminina brasileira. Objetivo: Examinar a associação entre as variáveis sociodemográficas e o estadiamento clínico inicial do tumor maligno de mama em mulheres, a partir do banco de dados de um Registro Hospitalar de Câncer. Método: Realizou-se um estudo analítico de dados secundários de 2.930 registros de casos de neoplasia maligna de mama em mulheres que receberam tratamento entre 2000 e 2006 em um hospital referência em oncologia no Espírito Santo. Após avaliação da completude dos dados, agruparam-se os registros por estadiamento inicial precoce e tardio e, então, aplicados os testes qui-quadrado e de regressão logística para identificação das variáveis com associação estatisticamente significante com a ocorrência do diagnóstico em estadio tardio. Resultados: As variáveis cor da pele e situação conjugal não apresentaram associação estatisticamente significante com a ocorrência do diagnóstico em estádio tardio, entretanto a baixa instrução e a origem do encaminhamento pelo SUS determinaram respectivamente 4,3 e 1,9 vezes mais chances para o diagnóstico em estadiamento tardio. Conclusão: Mulheres com baixo grau de instrução e dependentes do Sistema Único de Saúde tem mais chances de descobrir tumores da mama em estadiamentos tardios.
18577 Background: In 1984 WHO guidelines for cancer pain was proposed. Codeine was selected among several others drugs when pain ladder step II was required. Since then very few comparative studies have been performed. Codein is a weak opioid and its analgesic action is not completely understood. A possible conversion into morphine is postulated. To determine efficacy, safety and tolerability of codein in advanced cancer patient we designed a prospective cohort study. Methods 150 metastatic cancer patients were studied during six months. A standard zero to then table scale for pain rating was used. The malignacies were: prostate 15 (10%), breast 42 (28%), lung 33 (22%), colon 37 (24.6%), other cancer 23 (15.3%). 62 patients were under treatment (41.3%). Results: There were: 83 M (55.3%) 67 F(44,7%) and the mean age was 62 years. Mean initial and final pain score were 7.1 and 1.3 respectively. Codein dose range from 30 mg/day to 270 mg/day (mean dose 180 mg/day). The average time of use was 13,7 months. Severe toxicity was 0% and the most often side effect was constipation (38.7%). Adjuvant drugs were used in 97 patients (64.7%) of patients. Uncontrolled pain ocurred in 17 patients (11.3%). Conclusions: During the last decade a great increase in the range of opioid agents and formulations available have emerged. Codein still represents an excellent drug for patients with long life expectancy. Side effects are manageable and are mainly constipation. Pain control was achieved in the majority of patients. Codein showed a low toxicity profile with a high compliance rate. Economic reasons must be strongly consider in poor countries and codein represents a good alternative option. Future comparative studies addressing also quality of life should be performed. No significant financial relationships to disclose.
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