Objective: Recent data indicates an increasing incidence of thyroid cancer not accompanied by a proportional increase in mortality, suggesting overdiagnosis, which may represent a big public health problem, particularly where resources are scarce. This article aims to describe and evaluate the procedures related to investigation of thyroid nodules and treatment and follow-up of thyroid cancer and the costs for the Brazilian public health system between 2008 and 2015. Materials and methods: Data on procedures related to investigation of thyroid nodules and treatment/follow-up of thyroid cancer between 2008 and 2015 in Brazil were collected from the Department of Informatics of the Brazilian Unified Health System (Datasus) website. Results: A statistically significant increase in the use of procedures related to thyroid nodules investigation and thyroid cancer treatment and follow-up was observed in Brazil, though a reduction was noted for procedures related to the treatment of more aggressive thyroid cancer, such as total thyroidectomy with neck dissection and higher radioiodine activities such as 200 and 250 milicuries (mCi). The procedures related to thyroid nodules investigation costs increased by 91% for thyroid ultrasound (p = 0.0003) and 128% in thyroid nodule biopsy (p < 0.001). Costs related to treatment and follow-up related-procedures increased by 120%. Conclusion: The increase in the incidence of thyroid cancer in Brazil is directly associated with an increased use of diagnostic tools for thyroid nodules, which leads to an upsurge in thyroid cancer treatment and followup-related procedures. These data suggest that substantial resources are being used for diagnosis, treatment and follow-up of a potentially indolent condition.

Objective To assess the operative time indicators in a public university hospital.Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays.Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes.Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

No abstract

Objective: To describe the employment status of Brazilians with multiple sclerosis (MS). Methods: Analysis of a cross-sectional online survey including questions on demographic and occupational status at the time of diagnosis and survey completion, and time from the first symptom to diagnosis. Results: Of those who answered the survey, 804 Brazilians with MS were included. Median age of onset and current age were 28.3 and 36.2 years; median time to diagnosis and disease duration were 2.7 and 7.9 years; 67% held a university degree and 29% finished high school; 94% had a paid occupation contributing to the family income at least once in their lives, 77% were employed at the time of diagnosis but only 59% were employed at the time of survey. Longer disease duration, longer time to diagnosis and younger age at the first symptom, were identified as factors correlated with being unemployed. Conclusions: The rate of unemployment doubled after the first symptoms of MS, and only 59% of highly-educated people with MS in their productive years were employed. The longer time to diagnosis may imply treatment delay, and strategies focusing on early diagnosis and adequate treatment may favor employment retention and reduce disability related costs, such as social benefits and pension fund use.

RESUMOO tratamento de transtorno respiratório neonatal requer internação em UTIN com equipes especializadas e experientes, além de investimentos em recursos tecnológicos. Atualmente, esses recursos não são distribuídos de forma equitativa entre as regiões brasileiras, pois a decisão relativa ao tratamento é suscetível a custos. Este estudo fornece dados de internações dos neonatos com SDR em relação às internações neonatais no Brasil em 2015, refletindo o status, as limitações e a iniquidade dos cuidados intensivos neonatais nas regiões brasileiras, propiciando assim, base para comparações longitudinais. As bases utilizadas no desenvolvimento do estudo foram os gastos hospitalares com internação, dias de permanência geral, Unidades de Terapia Intensiva e óbitos. As informações foram extraídas do banco de dados do Sistema de Informações do DATASUS e construídas a partir das Autorizações de Internação Hospitalar (AIH's) e do Cadastro Nacional dos Estabelecimentos de Saúde (CNES), para levantamento das UTI's Neonatais. O estudo sugere que os gastos hospitalares no tratamento do neonato com SDR são elevados em função dos cuidados intensivos neonatais, que, apesar de considerados caros, proporcionam altos retornos em saúde para a quantidade de recursos que consome. A variabilidade geográfica influi de forma direta sobre os gastos e os cuidados, uma vez que há menor acesso a esses serviços, resultado da distribuição e da complexidade diferenciada de leitos de UTIN's entre as regiões brasileiras.Palavras-chave: síndrome do desconforto respiratório neonatal; Autorização de Internação Hospitalar SUS; custos hospitalares; unidade de terapia intensiva neonatal.

Maykon Andersom Pires de Novais RESUMOA Informática em Saúde no Brasil é uma área que desponta no horizonte acadêmico-científico de maneira promissora e atraindo profissionais de diversos segmentos acadêmicos e que busca em cursos de capacitação uma formação ampla e que lhe confira competência de atuação. Este estudo é de caráter exploratório e descritivo. Trata-se de pesquisa bibliográfica realizada com base na análise e interpretação de artigos, dissertações e teses. A presente pesquisa objetiva verificar a importância da informática em saúde e sua aplicação para processo de ensino e aprendizagem nos cursos de ensino superior nas Instituições Públicas. Conclui-se que há uma necessidade de investimentos e aplicação destes cursos em outras regiões do Brasil, e que a iniciativa de oferecer tais cursos a distância propicia um melhor acesso a esses cursos.Palavras-Chave: Saúde, Informática, Educação.* Trabalho de conclusão de curso apresentado a Universidade Federal de São Paulo -UNIFESP no ano de 2010, intitulado A importância da Informática em Saúde na Educação Superior nos Cursos da Área da Saúde.

Introduction Social participation is one of the guidelines of the Brazilian health system. Health councils are collegiate instances of participation established by Law 8.142/90. The most recent legal regulation for council organization and functioning was established through Resolution 453/2021. The institution of health councils has a permanent and deliberative nature to act in the formulation, deliberation and control of health policy implementation, including in economic and financial aspects. Objective To evaluate the compliance of health councils with the directives for the establishment, restructuring and operation of the councils from Brazil, based on Resolution 453/2012. Methods An exploratory, descriptive study that used the Health Council Monitoring System as a data source. Qualitative variables were selected to identify the characteristics related to the councils’ establishment (legal instruments for establishment), the strategies adopted for restructuring (budget allocation, existence of an executive secretariat, provision of a dedicated office) and the characteristics of the health councils’ operation (frequency of regular meetings, existence of a board of directors, the election of the board of directors). Results The study analyzed three groups of characteristics related to the constitution, strategies adopted for restructuring and the functioning of the councils. Regarding the constitution of the councils, the findings revealed that the vast majority was constituted in accordance with the legislation and, therefore, is in compliance with Resolution 453/2021. In the second group of characteristics that describe the restructuring of councils, the study found that less than half of registered councils are in compliance with the standard. And, finally, in the third group of characteristics, it was found that the boards have adopted different frequencies for regular meetings and approximately 50% of the boards studied have a board of directors. Conclusions The councils still do not meet the minimum conditions necessary to fulfil their role in the Unified Health System (SUS), as stipulated in Resolution 453/2021. This situation requires monitoring by public oversight agencies. Despite the increase in popular participation with the creation of the health councils, this study demonstrated that most councils still do not meet the minimum conditions for monitoring public health policy. The improvement of the Health Councils Monitoring System (SIACS) to become an instrument for monitoring the councils, with the definition of goals and results, may contribute to the organization of the councils and, therefore, to the realization of social participation in Brazil.

This article presents an analysis from the theoretical point of view on the evolution of the concept of Social Education. In order to do so, it evaluates the interdisciplinary characteristics involved in this proposal of engagement with society, elucidating and clarifying the governmental and non-governmental initiatives directed to the health area in Brazil, especially regarding the work developed by Community Health Agents as educators through a program of actions and procedures ensured by the implementation of the Family Health Program. As the work carried out by the groups of assistance to the populations, especially the less favored ones, is a set of activities interconnected and supported in each other, it is possible to follow the chain of each task force, whose purpose is to contribute to the well-being and promoting the quality of life throughout all Brazilian territory.