Igor Vilela Brum

Conhecimento de 820 mulheres atendidas no Hospital Universitário da Universidade Federal de Juiz de Fora sobre autoexame das mamas

Objetivos: Investigar a percepcao e o conhecimento de 820 mulheres usuarias do Hospital Universitario da Universidade Federal de Juiz de Fora acerca do autoexame das mamas, a forma pela qual tem adquirido conhecimento sobre esse exame, bem como a sua associacao com variaveis socioeconomicas. Metodos: Estudo transversal realizado com 820 mulheres usuarias do Hospital Universitario da Universidade Federal de Juiz de Fora, mediante entrevista estruturada. A associacao entre as variaveis foi feita pelo teste do ?2 . Resultados: Na amostra, 92,4% das pacientes tinham conhecimento sobre o autoexame das mamas. Os principais meios de informacao foram televisao, consulta medica e campanhas educativas com, respectivamente, 50,5%; 43,8 e 17,2%. Das entrevistadas, 68,8% consideram-se aptas a fazer o autoexame das mamas, e 61,3% o fazem. Destas, 62,4% o realizam mensalmente. Quanto ao momento ideal para realizacao do autoexame das mamas, 38,5% acreditam que seja logo apos a menstruacao; 20,5%, a qualquer momento; 17,7%, antes da menstruacao; 7,4%, durante a menstruacao e 15,9% nao sabem. Uma taxa de 55,7% acredita nao saber diferenciar o tecido mamario normal do nodulo durante o exame. Observou-se maior realizacao e conhecimento sobre o autoexame das mamas entre aquelas com renda superior a dois salarios-minimos (p=0,01). Conclusoes: Mesmo sendo uma pratica controversa, a maioria das mulheres adquire informacoes sobre o autoexame das mamas por meio de fontes leigas. Em decorrencia disso, mais da metade das mulheres nao sabe o momento ideal para a sua realizacao e nao se sente apta para realiza-lo, justificando uma necessidade de informacoes tecnicas adequadas e baseadas em evidencias.(AU) Objectives: To investigate the understanding and knowledge of breast self-examination among 820 women assisted at the University Hospital of Universidade Federal de Juiz de Fora, in addition to the manner in which they have acquired knowledge of this examination, and its association with socioeconomic variables. Methods: This was a cross-sectional study. Structured interviews were conducted with 820 women assisted at the University Hospital of the Universidade Federal de Juiz de Fora.The association between the variables was performed using the ?2 test. Results: 92.4% of the sample was aware of the breast self-examination. The main sources of information were television, medical consultation and educational campaigns, accounting for 50.5, 43.8 and 17.2%, respectively. Among the interviewed women, 68.8% considered themselves capable of performing the breast self-examination and 61.3% reported the habit of performing it. Among these, 62.4% perform it monthly. With regard to the best period to perform the breast selfexamination, 38.5% consider that it should be done immediately after menstruation, 20.5% at any time, 17.7% before menstruation, 7.4% during menstruation, and 15.9% do not know. A total of 55.7% believed they were not able to differentiate a normal breast tissue from a nodule during the exam. We observed higher occurrence and understanding of breast self-examination among women whose income was above two minimum wages (p=0.01). Conclusions: Despite being a controversial practice, most women acquire information about the breast self-examination by means of non-medical sources. As a consequence, over half of the women are not aware of the proper time to perform the exam as well as they do not feel capable of performing it. This justifies the need for technical and evidence-based adequate information.(AU)

Política Nacional de Saúde Integral da População Negra: implementação, conhecimento e aspectos socioeconômicos sob a perspectiva desse segmento populacional

A Politica Nacional de Saude Integral da Populacao Negra tem o objetivo de garantir a equidade na atencao a saude para esse segmento populacional. Tal medida possui um carater compensatorio em virtude das discriminacoes raciais existentes ao longo da historia do Brasil. A populacao negra apresenta maior vulnerabilidade social e economica, o que reflete uma menor expectativa de vida e maior susceptibilidade a agravos. O objetivo do estudo e investigar o conhecimento da populacao negra acerca da politica, seus potenciais beneficios e as dificuldades de acesso a saude. Trata-se de uma pesquisa transversal, descritiva e quantitativa. Foram realizadas entrevistas estruturadas com 391 individuos negros, usuarios do SUS, da cidade de Juiz de Fora. A amostra foi estratificada de acordo com raca (preto e pardo), renda e escolaridade. Cerca de 90% dos entrevistados relataram desconhecer a existencia de uma politica de saude para a populacao negra e 53% declararam uma possivel discriminacao racial. Observou-se tambem associacao positiva entre discriminacao e menor escolaridade e renda. Apesar de desconhecerem a existencia da PNSIPN, a maioria dos entrevistados aprovou seus objetivos, mesmo relatando a possibilidade de discriminacao dela advinda.

Does Knowing Someone with Breast Cancer Influence the Prevalence of Adherence to Breast and Cervical Cancer Screening

OBJECTIVE  To evaluate the prevalence of adherence to screening methods for breast and cervical cancer in patients attended at a university hospital and to investigate whether knowing someone with breast cancer, moreover belonging to the patients family, affects the adherence to the screening recommendations. METHODS  This was a cross-sectional and quantitative study. A structured interview was applied to a sample of 820 women, between 20 and 69 years old, who attended a university hospital in the city of Juiz de for a, MG, Brazil. For the analysis, the chi-square test was used to assess possible associations between the variables, and the significance level was set at p-value ≤ 0.05 for a confidence interval (CI) of 95%. RESULTS  More than 95.0% of the sample performed mammography and cervical cytology exam; 62.9% reported knowing someone who has or had breast cancer, and this group was more likely to perform breast self-examination (64.9%; odds ratio [OR] 1.5; 95% CI 1.12-2.00), clinical breast examination (91.5%; OR 2.11; 95% CI 1.37-3.36), breast ultrasound (32.9%; OR 1.81, 95% CI 1.30-2.51), and to have had an appointment with a breast specialist (28.5%; OR 1.98, 95% CI 1.38-2.82). Women with family history of breast cancer showed higher propensity to perform breast self-examination (71.0%; OR 1.53 95% CI 1.04-2.26). CONCLUSION  There was high adherence to the recommended screening practices; knowing someone with breast cancer might make women more sensitive to this issue as they were more likely to undergo methods which are not recommended for the screening of the general population, such as breast ultrasound and specialist consultation; family history is possibly an additional cause of concern.

Survival Study of Triple-Negative and Non–Triple-Negative Breast Cancer in a Brazilian Cohort

Objective: To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and identify potential prognostic factors. Methods: This hospital-based retrospective cohort study included 447 women with breast cancer treated at referral centers in Southeastern Brazil. Overall and disease-free survival were compared; prognostic factors were evaluated. Results: Triple-negative breast cancer corresponded to 19.5% of breast cancer diagnosis and was more prevalent among nonwhite and less educated women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 5-year overall and disease-free survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC, respectively (P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with nonwhite ethnicity, lower education level, lymph node involvement, and advanced stage. Conclusions: Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.

Percepção sobre queda e exposição de idosos a fatores de risco domiciliares

Resumo O objetivo deste artigo e descrever a percepcao sobre quedas dos idosos residentes na comunidade; mensurar a exposicao desses individuos a fatores de risco domiciliares relacionados; e avaliar a influencia do conhecimento sobre queda na adocao de medidas preventivas. O questionario FRAQ-Brasil foi aplicado a 473 idosos, juntamente com um questionario sobre exposicao a 20 fatores de risco domiciliares. Associacoes entre as variaveis foram analisadas utilizando o teste qui-quadrado com intervalo de confianca de 95%. A idade variou de 60 a 95 anos, com media de 70,6 anos; os entrevistados foram principalmente do sexo feminino (58,4%), e renda de 2 salarios minimos (46,3%); a media de acertos no questionario FRAQ-Brasil foi de 19,5 em ate 32 pontos e os idosos entrevistados estavam expostos, em media, a 7,8 fatores de risco domiciliares; 180 idosos disseram ja terem recebido informacoes sobre queda. A maioria da populacao idosa apresenta pouco conhecimento sobre queda. Individuos com idade mais avancada e com maior conhecimento sobre queda estao expostos a menos fatores de risco domiciliares, possivelmente pela maior adocao de medidas preventivas atraves da modificacao do ambiente domestico.OBJECTIVES to describe the awareness about falls among elderly people living in their households in communities, to measure the other risks that they are exposed to in their homes and to evaluate the influence that knowledge on falling brings in the adoption of preventative measures. METHOD The FRAQ-Brazil questionnaire was used on 473 elderly people as well as a questionnaire on elderly people being exposed to 20 household risk factors. Associations between the variables were analyzed using the chi-squared test with a confidence interval of 95%. RESULTS The age range was between 60 and 95 years with the average being 70.6 years. The majority of those interviewed were female (58.4%) who were earning 2 minimum wages (46.3%). The average amount of correct answers given with the use of the FRAQ-Brazil questionnaire was 19.5 out of 32 points and the elderly participants were, on average, exposed to 7.8 household risk factors. 180 of them stated that they had already received information on falls. CONCLUSION The majority of the elderly population displayed little knowledge on falls and were exposed to a variety of daily risk factors. Individuals who were more advanced in years and who had more knowledge on falls, were exposed to less household risk factors. This may well have been due to the adoption of preventative measures through changing domestic environment.

Metastatic breast cancer: clinicopathological features and survival according to the site of metastasis

Modelo do estudo: estudo de coorte retrospectivo. Objetivos: investigar aspectos clinicos, patologicos e sobrevida do câncer de mama metastatico de acordo com o sitio acometido pela metastase, osseo ou extraosseo. Metodologia: a populacao de estudo foi uma coorte de 124 mulheres com câncer de mama metastatico atendidas em hospital de referencia oncologica. A associacao entre variaveis sociodemograficas, tumorais e relativas ao tratamento e o sitio de metastase foi verificada atraves do teste qui-quadrado e as funcoes de sobrevida foram estimadas pelo metodo de Kaplan-Meier. Resultados: verificou-se metastase ossea isolada em 26,6% das pacientes e metastase extraossea isolada em 45,2%, sendo que o restante exibiu metastases em ambos os sitios. Entre as pacientes com metastase ossea isolada, 68,2% utilizaram hormonioterapia, em relacao a 44,9% daquelas com metastase extraossea (p=0,06); tumores com receptor de progesterona positivo foram observados em 63,6% e 43,3% das pacientes em cada grupo (ossea isolada versus extraossea), respectivamente (p=0,09). A sobrevida global em cinco anos foi 38,5% (IC95%: 18,6-58,2) para as pacientes com metastase ossea isolada e 24,8% (IC95%: 15,2-35,7) para aquelas com metastase extraossea. Ja o tempo medio de sobrevida apos o diagnostico de metastase foi de 19,6 meses nos casos de metastase ossea isolada e 12,1 meses naqueles com envolvimento extraosseo. Conclusoes: a presenca de positividade hormonal e o uso de hormonioterapia parecem estar associados a maior ocorrencia de metastase ossea isolada, que, por sua vez, sinaliza para maior tempo de sobrevida em relacao a metastase extraossea.

Percepção sobre queda como fator determinante desse evento entre idosos residentes na comunidade

factors to that, including intrinsic and extrinsic risk factors, as well as the awareness about falls, assessed by the Falls Risk Awareness Questionnaire (FRAQ-Brazil). METHOD: It consisted of a quantitative, transversal, and descriptive study, performed with 472 elderly persons through interview. Data were analyzed by the chi-squared test with a confidence interval of 95%. RESULTS: The average age of the sample was 70.6 years and most of them were female. Among the sample, 55.2% referred previous episodes of fall. The majority of them self-reported having diseases associated with gait disturbance and used medicines that could cause falls. It was observed less falls among elderly with higher level of awareness about risk factors. CONCLUSION: A high prevalence of accidental falls and exposure of the elderly persons to several independent and concomitant risk factors were observed. Greater awareness level about falls seems to be a preventive factor, presenting a higher association with falls than level of education and income.

Basic Life Support Knowledge and Interest Among Laypeople

Mailing Address: José Antonio Chehuen Neto Av. Presidente Itamar Franco, 1.495/1.001, Centro. Postal Code: 36016-320. Juiz de Fora, MG – Brazil. E-mail: igorbrum.med@gmail.com Basic Life Support Knowledge and Interest Among Laypeople José Antonio Chehuen Neto, Igor Vilela Brum, Débora Rodrigues Pereira, Letícia Gomes Santos, Silvia Lopes de Moraes, Renato Erothildes Ferreira Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG – Brazil