Barriers in health care to breast cancer: perception of womenGonçalves LLC, Travassos GL, Almeida AM, Guimarães AMDN, Gois CFL RESUMENObjetivo: Identificar las barreras en el acceso a la atención en salud percibidos por mujeres con cáncer de mama en tratamiento quimioterapéutico. Método: Estudio descriptivo-exploratorio, cuya muestra estuvo constituida por 58 mujeres con cáncer de mama en quimioterapia inscritas en el servicio ambulatorio público de oncología de Aracaju-Sergipe. La recolección de datos fue realizada entre octubre de 2011 a marzo de 2012, por medio de entrevistas semi-estructuradas. Los datos fueron procesados en el software SPSS, versión 17. Resultados: Entre las entrevistadas, 37 mu jeres (63,8%) relataron haber enfrentado por lo menos una barrera en la trayectoria de cuidado del cáncer de mama. Las barreras organizacionales o de los servicios de salud fueron las más citadas en los periodos de investigación y tratamiento del cáncer de mama. Conclusión: Las barreras deben ser consideradas en las políticas pú-blicas de salud y de los programas de control del cáncer de mama en Sergipe. DESCRIPTORES Mujeres Neoplasías de la mama Acceso a los Servicios de Salud Diagnóstico tardío Enfermería oncológica ABSTRACTObjective: Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy. Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17. Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer. Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe. DESCRIPTORS INTRODUCTIONBreast cancer has become a public health problem worldwide. In 2008, the estimate was of 1,380 new cases and 458,000 deaths from breast cancer. Among these, approximately 59% occurred in countries of low and middle income (1) . Most cases diagnosed in developing countries are in more advanced stages of the disease, which complicates treatment (2)(3)(4)(5) . Barriers to access to health services, incomplete or missing information, difficulties in infrastructure, socioeconomic, ethnic and geographical conditions are some of the problems that lead to delay in diagnosis, both from other diseases as neoplasms (3,5) .Breast cancer, when detected at early stages, has the best prognosis and ensures lower costs to the health system (6) . Due to do this fact, the access to health services is of paramount importance, and goes beyond the mere availability of resources, resulting from a combination of factors, such as favor...

OBJETIVOS: conhecer os aspectos clínicos e patológicos dos casos de câncer de mama feminino cadastrados num serviço público de oncologia de Sergipe. MÉTODOS: procurou-se fazer uma associação do estadiamento com as características presentes nos tumores. A coleta de dados foi realizada em 165 prontuários de mulheres cadastradas no período de 2005 a 2008 no ambulatório de oncologia do Hospital Cirurgia, localizado em Aracaju-Sergipe, por meio de formulário de coleta de dados, em 2009. RESULTADOS: identificou-se o carcinoma ductal invasivo como o tipo de neoplasia mamária mais frequente com 80,8% dos casos; 76 (46,1%) neoplasias foram diagnosticadas em estádio avançado (IIB, III e IV) e a mastectomia prevaleceu como tipo de cirurgia utilizado no tratamento independente do estadiamento. Quanto aos receptores hormonais todos apresentaram associação com o grau do estádio e, ainda, notou-se que a positividade do estrogênio e progesterona é fator de proteção para um pior prognóstico. CONCLUSÃO: é notável que os casos de câncer de mama estudados apresentam maior agressividade biológica, cursando com pior prognóstico, considerando o estádio clínico. Fazem-se necessárias ações de detecção precoce voltadas ao câncer de mama na atenção básica de Sergipe para redução da morbi-mortalidade, melhora da sobrevida e qualidade de vida entre as mulheres acometidas por essa neoplasia.

Introduction: Despite the success of antiretrovirals, human immunodeficiency virus (HIV) coinfections continue to cause mortality. We investigated the prevalence of coinfections in women with HIV/acquired immunodeficiency syndrome in Sergipe, Brazil. Methods: We conducted a cross-sectional study. The coinfections investigated were syphilis, hepatitis B and C, toxoplasmosis, rubella, tuberculosis, and cytomegalovirus. Results: Among the 435 women, 85 (19.5%) had coinfections. The most prevalent was HIV/syphilis, followed by tuberculosis, toxoplasmosis, hepatitis C, hepatitis B, and rubella. Additionally, 300 (96.2%) were seropositive for cytomegalovirus immunoglobulin G. Conclusions: Despite significant progress in the treatment for people with HIV, coinfections continued to affect this population.

Effects of two kinds of aerobic training on body fat content and serum lipid profile in cadets Study aim: To assess the effects of aerobic training on body fat content and serum lipid profile. Material and methods: A group of 45 male members of Brazilian Military Police Academy, aged 18 - 32 years, were subjected randomly assigned into 3 subgroups and to 12-week programmes: aerobic fatmax zone training (FG; n = 18), traditional military training (TM; n = 15) and non-training control group (C; n = 12). Body fat content (3 skinfolds), serum lipid profile (total cholesterol, LDL, HDL and triglycerides), waist circumference (WC) and O2max (12-min test) were determined. Results: O2max significantly (p<0.05) increased and body fat content decreased in both experimental group compared with the control one. Significant (p<0.05) reductions in WC and LDL vs. control group were observed in the TM group only. Conclusions: The applied aerobic training induced a decrease in percent body fat irrespectively of the kind of training.

, coordenadora local do Dinter, pela colaboração e parceria. A todos os docentes do Programa Interunidades que, ao transmitirem seus conhecimentos, contribuíram para o meu amadurecimento e aprimoramento profissional. À Profa. Dra. Ana Maria de Almeida que, para mim, não foi somente uma orientadora dedicada e competente, mas uma amiga. À Clínica Onco Hematos Ltda. responsável pelo ambulatório de oncologia da Fundação Beneficente Hospital Cirurgia, por ter concedido a realização da coleta de dados e a todos os seus colaboradores. À Universidade Federal de Sergipe por possibilitar a realização deste doutorado. À Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES, edital 005/2009 Ação Novas Fronteiras da CAPES/MEC. RESUMO Gonçalves, L.L.C. Trajetória de mulheres com câncer de mama: dos sinais e sintomas ao tratamento. 2013. 143 f. Tese (Doutorado)

Objective: to identify which early detection measures that the women had access to, in which way the neoplasm was detected and clinic stage it was found. Method: forty women undergoing chemotherapy treatment in the city of Aracaju, Sergipe state, Brazil were interviewed from March through October 2009 by an applied questionnaire after free and informed patients’ consent. Method: descriptive-exploratory study with a quantitative approach and the data analysis was done by EPI6 software version 6. The Research Ethics Committee of Sergipe Federal University approved this research via the protocol CAAE-1533.0.000.107-08. The sample consisted of 44 women who underwent chemotherapy for breast cancer enrolled in outpatient oncology Results: number of women with breast cancer has grown quickly. The results showed deficiency in early detection that had reflected in more frequency of aggressive surgical intervention and pre-surgical treatment because of advanced stages and the presence of metastases. Conclusion: the necessity to execute early detection should be recognized by administrators and health professionals to offer less aggressive treatments that result in a greater quality of life and better prognosis. Descriptors: breast neoplasm’s; diagnosis; combined modality therapy; prognosis.RESUMOObjetivo: identificar as medidas de detecção precoce a que as mulheres com diagnóstico de câncer de mama tiveram acesso, de que forma a neoplasia foi descoberta e em que estadio clínico se apresentava. Método: estudo de caráter descritivo-exploratório com abordagem quantitativa, realizado na clínica Onco Hematos Cirurgia, em Aracaju, Sergipe-SE. O período para a coleta dos dados com um instrumento de pesquisa abrangeu os meses de março a outubro de 2009, após aprovação do projeto pelo Comitê de Ética em Pesquisa da Universidade Federal de Sergipe com CAAE-1533.0.000.107-08. A amostra foi constituída por 44 mulheres que realizavam quimioterapia para câncer de mama, cadastradas no ambulatório de oncologia. Os resultados foram apresentados por meio de números absolutos e percentuais obtidos a partir de tabulação do software EPI6, versão 6 e foram comparados com estudos sobre o tema em literatura nacional e internacional. Resultados: o índice de mulheres com câncer de mama tem crescido vertiginosamente. Os resultados revelaram deficiência na detecção precoce que se refletiu na maior frequência de intervenção cirúrgica agressiva e tratamento pré-cirúrgico devido ao estadiamento avançado e presença de metástases. Conclusão: a necessidade da realização das ações de detecção precoce deve ser reconhecida por gestores e profissionais de saúde para que se ofereçam tratamentos menos agressivos que resultem em maior qualidade de vida e melhor prognóstico. Descritores: neoplasias da mama; diagnóstico; terapia combinada; prognóstico.RESUMENObjectivo: identificar las medidas de detección precoz que las mujeres tenían acceso, como se detectó la neoplasia y que estratificación clínica se ha encontrado. Método: cuarenta cuatro mujeres que realizan tratamiento de quimioterapia en la ciudad Aracaju, el estado del Sergipe, Brasil fueran entrevistadas entre marzo y octubre de 2009 por búsqueda aplicada después de autorización de los pacientes libre e esclarecida. Enfoque de carácter descriptivo-exploratorio, se pronunció sobre datos cuantitativos y el análisis fue hecho por el software EPI6 la versión 6. El Comité de Ética del Pesquisa de la Universidad Federal de Sergipe aprobó el estudio por el parecer nº CAAE-1533.0.000.107-08. Resultados: número de mujeres con cáncer de mama crece rápidamente. Los resultados mostraron que la deficiencia en la detección temprana había reflejado en la frecuencia de intervención quirúrgica más agresiva y el tratamiento pre-quirúrgico debido a estratificación avanzada y la presencia de metástasis. Conclusión: la realización de acciones de detección temprana debe ser reconocida por los administradores y profesionales de la salud para ofrecer tratamientos menos agresivos que resulta  en una mayor calidad de vida y un mejor pronóstico. Descriptores: neoplasias de la mama; diagnóstico; terapia combinada; pronóstico.

Objectives This study aimed to compare the climacteric symptoms, quality of life indices, and self-care attitudes in women before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods This cross-sectional study was conducted between January 2020 and September 2021. The sample consisted of 342 climacteric women who were divided into two groups: before the pandemic (BP group; n = 62) and during the pandemic (DP group; n = 280). The Menopause Rating Scale and Women’s Health Questionnaire were used to measure the health-related quality of life and degree of climacteric symptoms reported by women. Results During the COVID-19 pandemic, women were able to decrease their somatic symptoms derived from the climacteric period (BP group: 7.84 ± 4.46, DP group: 5.94 ± 9.20; P = 0.003). Conclusions There was no worsening in the self-reported symptoms, quality of life, and self-care attitudes of climacteric women because of the COVID-19 pandemic. Moreover, only somatic symptoms decreased during the pandemic.

Objective: To analyze predictors of 5-year survival in women with breast cancer in the state of Sergipe.Materials and methods: This is a retrospective cohort study. This study included 100 women aged between 21 and 77 years diagnosed with breast cancer undergoing adjuvant or neoadjuvant chemotherapy in a public tertiary hospital from August 2011 to December 2012. All women were followed up for 5 years or until the date of death. There was no loss in follow-up. Data were collected during the field visit to the specialized health unit and included demographic and socioeconomic variables, tumor staging at diagnosis, patient paths for presentation to health professionals, initial treatment in primary care and treatment. We used a three-stage model: the first (“patient delay”); the second (“delay in diagnosis”) and the third (“delay in treatment”). The statistical analysis was performed using the MedCalc version 18 statistical software. The study was approved by the Human Research Ethics Committee of the Federal University of Sergipe (CAAE: 0196.0.107.000-11). Written informed consent was obtained from all particip nts.Results: Tumor staging [risk ratio (HR) = 3.41, p = 0.046] was an independent factor that affected the overall survival curve for women with breast cancer. The overall 5-year survival rates found for women with tumor staging IA-IIB compared to tumor staging IIIA-IV were 88.5% and 59.5%, respectively. Through binary logistic regression with forced entry method, it was evident that age (OR = 2.58, p = 0.050), delay in the first stage (OR = 2.57, p = 0.046) and tumor staging (OR = 3.99, p = 0.042) were predictors of mortality in women with breast cancer. Conclusions: Our results highlight the need to strengthen health education actions in primary health care and the implementation of an organized and permanent screening program for the early detection of breast cancer.