RESUMO A Declaração de Óbito (DO) é o documento-base do Sistema de Informações sobre Mortalidade, do Ministério da Saúde. Contudo, trata-se de um assunto pouco abordado na formação médica continuada. O objetivo deste trabalho é avaliar o nível de conhecimento sobre questões básicas e de ordem prática no preenchimento e emissão da DO em alunos do 12º período do curso médico da Universidade Federal do Rio Grande do Norte (UFRN), em médicos residentes e em médicos docentes do Complexo Hospitalar da UFRN. Foram aplicados questionários com 11 questões de mútipla escolha, elaborado de acordo com o Manual de Preenchimento de Declaração de Óbito. Participaram da pesquisa 45 alunos, 66 médicos residentes e 96 médicos professores. Os médicos residentes obtiveram a melhor média de acerto entre as categorias. Nenhuma das três categorias obteve média de acertos de 70%. Considerando o tempo de formação em relação ao número de acertos, observou-se que, para cada ano de formação, em média, a porcentagem de acerto diminui em 0,485%. Este estudo evidencia a importância de uma educação médica continuada nas faculdades de Medicina para um adequado preenchimento e emissão da DO.

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Objetivo: Correlacionar as pacientes com resultado mamográfico BI-RADS 4 ou 5 submetidas a mamotomia e comparar os achados com os encontrados na histopatologia. Método: Foram selecionadas 111 pacientes as quais apresentavam lesões mamárias não palpáveis detectadas na mamografia e que realizaram mamotomia na Clínica de Oncologia e Mastologia de Natal. As amostras foram enviadas para o laboratório Dr. Getulio Sales, após radiografia das peças, e todas as pacientes tiveram de colocar clipe de titânio. Resultados: A faixa etária predominante foi de 41-50 anos (40,5%); cerca de 30,6% possuía histórico familiar de câncer de mama; entre as selecionadas, 97,3% possuíam classificação 4 do BI-RADS e 2,7% tinham classificação 5, predominando, em ambos os casos, as microcalcificações como indicação de mamotomia. A distribuição entre lesões benignas e malignas foi de 70 e 30%, respectivamente. A prevalência de lesões malignas foi de carcinoma ductal in situ (58%). Houve significância estatística com relação à suspeição de malignidade de acordo com o BI-RADS 4 e 5, p=0,018 [IC95%0,28 (0,209-0,383)]. O grau de associação verificado por meio da odds ratio mostra que o grupo BI-RADS 5 tinha 72% menos chance de ser benigno quando comparado ao grupo BI-RADS 4. Não houve relato de complicações nas pacientes submetidas a mamotomia no presente estudo. Conclusão: A mamotomia mostrou-se um método seguro no diagnóstico de lesões suspeitas (BI-RADS 4 e 5), estando dentro do observado na literatura.PALAVRAS-CHAVE: Câncer de mama; diagnóstico precoce; mamografia. RESUMO ABSTRACTObjective: To correlate patients with BI-RADS 4 or 5 mammographic results submitted to mammotomy and compare these findings to histopathological ones. Method: We selected 111 patients with non-palpable breast lesions detected on mammography and who underwent mammotomy at Clínica de Oncologia e Mastologia de Natal. The samples were sent to the laboratory Dr. Getulio Sales, after x-ray of the pieces, and all patients had to use a titanium clip. Results: The prevalent age group was 41-50 years (40.5%); approximately 30.6% had a family history of breast cancer; among the patients selected, 97.3% had a BI-RADS 4 classification and 2.7%, a BI-RADS 5; with microcalcifications being the main reason for mammotomy indication in both cases. The distribution of benign and malignant lesions was 70 and 30%, respectively. The prevalent malignant lesion was ductal carcinoma in situ (58%). Clinical suspicion of malignancy according to BI-RADS 4 and 5 was statistically significant, p=0.018 [95%CI 0.28 (0.209-0.383)]. The degree of association verified through odds ratio showed that the BI-RADS 5 group had 72% less chance of having a benign lesion when compared to the BI-RADS 4 group. There were no reports of complications in patients submitted to mammotomy in the present study. Conclusion: Mammotomy proved to be a safe method to diagnose suspicious lesions (BI-RADS 4 and 5), and its results fit what is observed in the literature.

Objective: To analyze the prevalence of access to prenatal care in the first trimester of pregnancy among black women compared to other races/ethnicities through a systematic review and meta-analysis.Methods: Searches were carried out at PUBMED, LILACS, Web of Science, Scopus, CINAHL, and in the grey literature. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulatesd and analyzed qualitatively and quantitatively through meta-analysis.Results: Black women had the lowest prevalence of access to prenatal services in the first trimester, with prevalence ranging from 8.1% to 74.81%, while among white women it varied from 44.9 to 94.0%; 60.7% of black women started prenatal care in the first trimester, while 72.9% of white women did so.Conclusion: Black women compared to other racial groups had lower prevalence of access to prenatal care, with less chance of access in the first trimester, and it can be inferred that the issue of race/skin color is an important determinant in obtaining obstetric care.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020159968_, PROSPERO CRD42020159968.

Background: The Corona Virus Disease, 2019 (COVID-19) pandemic revealed many social disparities that already exist in countries that have social inequalities in their historical context. Studies have already been published on the epidemiological and clinical characteristics of population groups considered to be at risk where they reveal that Black people are at greater risk of becoming ill and dying from this cause. In this context, this protocol describes a systematic review that aims to analyze the association of race as the higher risk for illness and death due to COVID-19. Methods: This protocol will be developed based on the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P). For this, we will conduct searches in the PubMed, Web of Science, Scopus, Lilacs, and ScienceDirect databases in the search for cross-sectional studies. All cross-sectional studies that analyzed hospitalization and death by COVID-19 as race in its determinant will be included. The search will be carried out by 2 independent researchers who will carry out the selection of articles, then the duplicate studies will be removed and screened using the Rayyan QCRI application. To assess the risk of bias, the instrument proposed by Downs and Black will be used. Meta-analyzes and subgroup analyzes will be carried out according to included data conditions. Results: Based on this review, it will be possible to carry out a high-quality synthesis of available evidence that brings race as a factor for illness and death by COVID-19 and to verify which race is most affected by this disease. Conclusion: The relevance of this systematic review to the current context is considered, as it has a high potential to assist in the development of public health strategies and policies that address existing racial differences. Record of systematic review: CRD42020208767.

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