Resumo Introdução Apesar dos esforços, a mortalidade por câncer de mama se mantém elevada no Brasil e é mais frequente em regiões em que o acesso aos serviços de saúde é dificultado ou inexistente. Uma das recomendações do Instituto Nacional do Câncer (INCA) para reduzir a mortalidade é melhorar o acesso ao diagnóstico, realizando-o em até 60 dias após a suspeita. Objetivo Estabelecer o tempo decorrido (em dias) entre a suspeita e o diagnóstico do câncer de mama, subdividindo os intervalos entre os eventos: consulta médica na atenção básica; mamografia ou ultrassonografia; consulta médica especializada; biópsia; consulta médica para conclusão do diagnóstico. Métodos Estudo descritivo e seccional, realizado com 45 mulheres atendidas em um serviço público de saúde, com diagnóstico de câncer de mama efetivado em 2013. Resultados A média da demora foi de 142,6 ± 10,1 dias (12-451), com 60% dos diagnósticos efetivados entre 120 e 180 dias, e chance de efetivação do diagnóstico em até 60 dias para 8,9% da amostra. Conclusão Há necessidade de implementação efetiva das linhas de cuidado na rede de atenção oncológica, com pactuação dos fluxos entre os serviços para agilizar o acesso à assistência integral às mulheres.
Gastroesophageal reflux disease affects 40% of the population in industrialized countries. GERD has a negative impact on the quality of life of affected patients. Although PPIs induce a good response in the control of symptoms, the need for prolonged use of the medication and the fact that more than a third of the patients have symptoms even after its correct use, make surgery, an alternative for the treatment of the disease. The aims of this study were to compare the quality of life related to GERD before and after MIS surgical treatment of GERD and/or hiatus hernia, and to analyze the results and complications of the MIS treatment of GERD. Methods: For retrospective analysis, the electronic database of patients with indications for surgical treatment due to GERD and/or patients with sliding or paraesophageal hernias was examined. The study included patients from Hospital Universitário Gaffrée e Guinle and the Postgraduate Course in General Surgery at PUC-Rio (Rio de Janeiro, Brazil) who underwent surgery using video laparoscopy or robotic surgery between January 2013 and March 2020. This is an observational, longitudinal, descriptive study with retrospective analysis of the data. Surgical treatment was indicated due to incomplete response to clinical treatment, young age with persistent symptoms, or complications of GERD. Patients with hiatus and/or paraesophageal hernia with indication for surgical treatment were included. Results: The study evaluated 160 patients who underwent anti-reflux surgery by laparoscopic or robotic surgery in the period from 2013 to 2020. A total of 88 women and 72 men were operated, mean 46.6 ± 13.7 years. An improvement in the preoperative QS-GERD scores compared to the postoperative scores was observed (27.56 ± 10.93 vs 1.4 ± 2.47, p < 0.
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