HPV (Human Papillomavirus) is an adenovirus of the Papillomaviridae family with approximately 200 subtypes (subdivided into low and high oncogenic risk groups), responsible for almost 99% of cervical cancers. Worldwide, there are more than 570,000 new cases and more than 311,000 women die each year from cervical cancer; for Brazil, the estimate is of more than 16,000 new cases per year. It is known that cervical cancer is one of the most easily preventable forms of cancer, as there is a highly effective vaccine against HPV. However, the morbidity and mortality rates correlated with human papillomavirus are still concerning, especially in less developed countries. In 2020, the WHO (World Health Organization) presented three goals to achieve by 2030 the worldwide extermination of cervical cancer; among these goals is vaccination. Is the world preparing for this battle? The present work is an integrative review, comparing national and international guidelines for HPV vaccination published in the last five years in the consulted databases, using the descriptors "cervical cancer", "prevention" and "guideline" and the boolean operator "and", from which nine articles were selected. The study made it possible to compare international and national guidelines for vaccination against HPV, showing that developed countries implemented the HPV vaccine longer ago and follow the WHO recommendations more rigorously and effectively than underdeveloped or developing countries. Adopting a single dose as a strategy, as suggested by the WHO in April 2022, could be an important step towards increasing coverage and providing protection for a greater number of girls who do not have access to HPV immunization.
GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis and treatment of the aforementioned pathology results in inadequate risk classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to compare the different national and international guidelines in the management of GTD, through an integrative review. Nine articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 -2 weeks until normalized; in low-risk GTN (Gestational Trophoblastic Neoplasm
RESUMO Este estudo objetivou mostrar que a espiritualidade é um importante fenômeno estratégico capaz de ajudar o indivíduo a ressignificar suas atitudes, rever comportamentos, e manter a saúde mental em tempos de reorganização social. A pandemia da covid-19, causada pelo Coronavírus, tornou-se um dos maiores desafios da saúde pública. No Brasil, as adversidades enfrentadas, diariamente, são ainda maiores em virtude da imensa desigualdade social que o país apresenta. Essa experiência vem amealhando histórias carregadas de sofrimento e muita dor causando impactos em toda a coletividade. Medidas de segurança impostas pelo governo como forma de evitar a proliferação do vírus, contágio, adoecimento e óbitos vêm reduzindo o contato social entre as pessoas causando inúmeros problemas de ordem psíquica.
Objetivo: Avaliar os principais fatores de risco para Trombose Venosa Profunda (TVP) em pacientes gestantes e puérperas e se há relação do COVID-19 com elevação dos casos. Metodologia: Revisão sistemática de literatura, no qual foram realizadas buscas nas plataformas eletrônicas PubMed, LILACS e Scielo, utilizando os descritores: deep venous thrombosis, pregnancy e COVID-19. Resultados: A amostra resultou em 15 artigos. 93,3% das pesquisas afirmam que mulheres no período gestacional ou puerperal apresentam maior probabilidade de desenvolver TVP devido a alterações fisiológicas do período, com 26,6% dos estudos totais demonstrando fatores de risco para piora do quadro, como cardiopatias, gestação em idade superior a 35 anos, parto cesárea, cirurgia recente entre outros. Não foi relatado em nenhum estudo o aumento de incidência dos casos de TVP em gestantes infectadas pelo vírus SARS-CoV-2, contudo 20% dos artigos demonstram o aumento do número de complicações associadas a infecção, como parto prematuro, aborto e óbito fetal. Conclusão: Há riscos elevados para eventos trombóticos na gestação, especialmente em gestantes com fatores de agrave, como os desencadeadores da tríade de Virchow (estase, hipercoagulação e dano vascular), com a necessidade de atenção especial a essas pacientes. Não há associação estabelecida entre aumento de casos de TVP com infecção por COVID-19, recomendado o uso profilático de Heparina de Baixo Peso Molecular (HBPM) nestas pacientes, embora sejam necessários mais estudos sobre o assunto em virtude do pouco tempo de aparecimento da doença.
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