Ana Sílvia Whitaker Dalmaso

O agente comunitário de saúde e suas atribuiçöes: os desafios para os processos de formaçäo de recursos humanos em saúde

Acredita-se que por serem (os agentes) pessoas do povo, nao so seassemelham nas caracteristicas e anseios deste povo, como tambempreenchem lacunas, justamente por conhecerem as necessidadesdesta populacao. Acredito que os agentes sao a mola propulsorapara a consolidacao do Sistema Unico de Saude, a organizacao dascomunidades e a pratica regionalizada e hierarquizada deassistencia, na estruturacao dos distritos sanitarios. Ser agente desaude e ser povo, e ser comunidade, e viver dia a dia a vida daquelacomunidade.(...) E ser o elo de ligacao entre as necessidades desaude da populacao e o que pode ser feito para melhorar suascondicoes de vida. E ser a ponte entre a populacao e os profissionaise servicos de saude. O agente comunitario e o mensageiro de saudede sua comunidade. (Dirigente da Fundacao Nacional de Saude,Brasil, 1991, p.5)

Evidence for benefits from treating cervical ectopy: literature review

CONTEXT AND PURPOSE Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervical ectopy. METHODS The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted. RESULTS The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment. CONCLUSIONS 1) No data were found in the medical literature to support routine treatment for ectopy; 2) Treatment could be recommended for symptom relief, but more symptoms are attributed to ectopy than could be demonstrated in a controlled study; 3) Further studies to test the hypothesis of protection against cervical cancer associated with treatment are necessary.