Background: The diagnosis of breast cancer requires a complicated series of diagnostic exams. The present study addressed the delay of patients who used publicly and privately financed diagnostic services. Non-governmental organizations (NGOs) donated diagnostic mammograms and biopsies.Design and Methods: Data from 304 patients were obtained from two Brazilian referral centres. In one referral centre (FAP), diagnostic mammography, clinic-histopathological exam and immunohistochemistry were outsourced, whereas in the other centre (HNL), these services were integrated. Cox regression, Kaplan-Meier analysis and non-parametric tests were used to compare variables and time intervals.Results: If diagnostic mammography was financed privately and covered by private health insurance, the likelihood of a delay of >90 days between the first medical visit and the initiation of treatment decreased 2.15-fold (95%CI: 1.06- 4.36; p=0.033) and 4.44-fold (95%CI: 1.58-12.46; p=0.004), respectively. If the clinic-histopathological exam was outsourced (FAP) and publicly or privately financed, the median time between diagnostic mammography and the diagnostic result was 53 and 65 days in the integrated (HNL) and outsourced public system, compared to 29 days in the outsourced private system (p<0.050). The median time between the first medical visit and the diagnostic results of patients who were supported by NGOs, who financed their diagnostic services privately, and who used exclusively public diagnostic services was, respectively, 28.0, 48.5 and 77.5 days (p<0.050).Conclusion: Patients who used privately financed health services had shorter delays. Compared to outsourcing, the integration of the publicly financed clinic-histopathological exam diminished the delay. The support of patients by NGOs accelerated patient flow.

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.

Background: System delay (SD) is a leading cause of advanced stage of disease and poor prognosis among Brazilian breast cancer patients. Methods: Cox regression and Kaplan-Meier analysis were used to identify variables that contributed to SD among 128 breast cancer patients. Time intervals between first medical consultation and treatment initiation were compared among patients of two referral centres: Patients of a referral centre with outsourced (FAP), respectively, integrated (HNL) diagnostic services. Results: Women who used a specialized private clinic at the beginning of patient flow had an 2.32 fold increased chance (95% CI: 1.17-4.60; p = 0.016) of hospital admission within 90 days after first medical consultation, compared to women who used a public health care provider (HCP). Of 73 and 34 patients of the FAP hospital and the HNL, respectively, 10 (13.7%) and 11 (32.5%) used one HCP prior to hospital admission (p = 0.000). The median time between first medical consultation and treatment initiation was 150 days. The median time between first medical consultation and hospital admission was 136.0 and 52.0 days for patients of the FAP hospital, respectively the HNL (p < 0.050). The median time between first medical consultation and diagnostic mammography was 36.5 and 23.0 days for patients from the FAP hospital and the HNL (p < 0.050). Conclusions: Usage of public diagnostic services was associated with increased SD, whereas the usage of private diagnostic services diminished it. The usage of a lower number of HCPs accelerated patient flow.

Objetivo: Analisar as atuais publicações sobre o controle térmico do recém-nascido, com intuito de revelar o cenário atual literário, tendo em vista a alta taxa de mortalidade neonatal. Método: Trata-se de um estudo descritivo que utilizou a revisão integrativa realizada através de pesquisa em bancos de dados como Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e BDENF. Resultados: A termorregulação é um dos fatores determinantes para o êxito do equilíbrio cardiocirculatório e respiratório do recém-nascido logo após o nascimento. Conclusão: Conclui-se que a estabilidade térmica é uma parte extremamente importante dos cuidados neonatais, no qual a maioria dos artigos revela que o aquecimento adequado do recém-nascido tenha maior relevância para se obter o controle térmico, bem como esta temática necessita-se de mais estudos devido às graves consequências que esta instabilidade causa para o recém-nascido.

Este estudo teve como objetivo realizar uma revisão bibliográfica sobre a influência da suscetibilidade genética na incidência e mortalidade de COVID-19. Trata-se de uma revisão descritiva da literatura realizada nas bases de dados PUBMED e Science direct utilizando os seguintes descritores: genetic susceptibility” AND “COVID-19”. Os critérios de inclusão foram artigos científicos disponíveis gratuitamente, nos idiomas inglês, espanhol e português e que foram publicados em 2020. Foram excluídos os artigos duplicados entre as bases. Ao final 58 estudos seguiam os critérios estabelecidos. Os genes ACE2 e TMPRSS2, têm potencial para intervenção profilática e terapêutica nos estágios iniciais de infecção por SARS-CoV-2, desempenhando um papel crucial para a entrada do vírus nas células hospedeiras. Além disso, o lócus do Antígeno Leucocitário Humano (HLA), parece ser crucial para influenciar a suscetibilidade e a gravidade do COVID-19. Indivíduos do sexo masculino apresentam uma maior taxa de mortalidade e de gravidade para a COVID-19, sendo relacionado a uma expressão mais significativa de ACE2 e diferenças na regulação epigenética de ACE2. A suscetibilidade genética pode contribuir para a variabilidade clínica interindividual associada ao COVID-19, permitindo uma avaliação de risco baseada em evidências levando a medidas preventivas personalizadas e opções terapêuticas.