Origin-destination flows in chemotherapy for breast cancer in Brazil: implications for pharmaceutical services

Abstract

This study maps and analyzes patient flows for breast cancer chemotherapy in order to identify the potential implications for organization of pharmaceutical services in the cancer care network. An ecological study design sought to correlate the place of residence with place of care for breast cancer patients. All chemotherapy procedures financed by Brazil’s Unified Health System (SUS) and performed from January to December 2013 were included. Flows were mapped using TerraView® software. A total of 1 347 803 outpatient chemotherapy procedures were delivered by 243 cancer care units located in 156 municipalities. Seventeen cities concentrated approximately 50.0 % of the procedures. A total of 8 538 origin-destination flows were generated and 49.2% of procedures were performed in services located outside the municipality in which the patient resided. Context challenges, related to inequality of access to chemotherapy and hindrances in planning and management of pharmaceutical services, were discussed.

Estratégias adotadas para a garantia dos direitos da pessoa com câncer no âmbito Sistema Único de Saúde (SUS)

“…A restrição de cenários de atendimento aos pacientes oncológicos pode resultar em diminuição importante na sobrevida e na qualidade de vida dos sobreviventes do câncer 2 . Dificuldades relacionadas aos diversos serviços necessários ao controle do câncer têm sido apontadas na literatura, tais como: i) a distância a ser percorrida até um centro de tratamento oncológico, significando uma grande barreira de acesso 19 ; ii) o longo tempo de espera para se realizar o diagnóstico da doença, devido à sobrecarga do limitado número de laboratórios de anatomopatologia e histopatologia 20 ; iii) a escassez de profissionais capacitados para atuar na atenção ao câncer, nos diversos níveis de atenção 21 . Suplantar essas e outras dificuldades para expandir a rede é um desafio necessário:…”

Perfil de utilização de medicamentos antineoplásicos entre indígenas atendidos pelo Sistema Único de Saúde

“…A fonte de dados foi o Sistema de Informação Ambulatorial (SIA-SUS), do Departamento de Informática do SUS (DATASUS), considerando apenas as Autorizações de Procedimentos de Alta Complexidade para Quimioterapia (APAC-Quimio). O número de procedimentos autorizados não corresponde necessariamente ao número de pacientes atendidos nas unidades habilitadas, pois cada autorização é válida para até três meses 5 .…”

Identification of New Inhibitors with Potential Antitumor Activity from Polypeptide Structures via Hierarchical Virtual Screening

“…T cells are a type of lymphocyte that grow in the thymus and are responsible for the immunological recognition of pathogens. The extracellular proteins, captured by antigen-presenting cells (APCs), are degraded and resulting peptides bind to T-cell receptors (TCRs) determining the immune response [6,7].…”

“…It was found that when the endothelium was stimulated, an exceptionally increased interaction with the endothelium was observed in approximately half of the cases studied. In these patients, the neoplastic population expressed α4β1, which conferred the ability to adhere strongly to the stimulated endothelium via α4β1 ligand, vascular cell adhesion molecule 1 (VCAM-1) and concluded that constitutive integrin expression/function, intrinsic activation state of the cell and the ability of cytokines to modify integrin-mediated production are combined to determine the different clinical patterns of disease observed in lymphocytic leukemia [6,7,8].…”