Avaliação do nível de satisfação dos usuários na atenção básica de saúde em um município da região metropolitana de Porto Alegre: programa de saúde da família x tradicionais

Este artigo tem como objetivo conhecer a opinião dos usuários da Atenção Básica sobre o Programa deSaúde da Família (PSF) e comparar as opiniões dos usuários atendidos pelas equipes de PSF com osatendimentos pelo sistema tradicional (Unidades Básicas de Saúde - UBS). Trata-se de um estudoexploratório-descritivo com abordagem quantitativa realizado com setenta (70) usuários atendidos narede básica de saúde após receberem atendimento por um profissional de saúde. Utilizou-se um instrumentocom perguntas abertas e fechadas, obedecendo aos aspectos éticos. Foi possível conhecer como ousuário define o Programa de Saúde da Família (PSF) e qual o impacto do mesmo na sua saúde ou de suafamília.Palavras-chave: Atenção Básica, usuários, avaliação, PS

Phase II study of neo-adjuvant chemotherapy with paclitaxel and cisplatin given every 2 weeks for patients with a resectable squamous cell carcinoma of the esophagus

BACKGROUND: We have previously reported a favourable response rate in patients with advanced esophageal cancer after treatment with a biweekly regimen of paclitaxel and cisplatin. In this study we investigate the feasibility and efficacy of this regimen in a neo-adjuvant setting. PATIENTS AND METHODS: Patients with resectable squamous cell carcinoma of the esophagus received paclit-axel 180 mg/m(2) and cisplatin 60 mg/m(2) every 2 weeks. Patients received three courses and responding patients received three additional courses; thereafter, patients were referred for surgery. Patient characteristics of 50 eligible patients were as follows: male, 60%; median age, 62 years (range 45-78); median World Health Organization performance status of 1 (range 0-2). RESULTS: Ninety-four per cent of patients received at least three courses of chemotherapy. Haematological toxicity consisted of National Cancer Institute-Common Toxicity Criteria grade 3 or 4 neutropenia in 71% of patients, with neutropenic fever occurring in only two patients (4%). The overall response rate was 59%. Pathological examination showed tumour-free margins in 38 patients. In seven patients no residual tumour was found. The median overall survival was 20 months and the 1- and 3-year survival rates were 68% and 30%, respectively. CONCLUSIONS: This dose-dense schedule of paclitaxel and cisplatin administered biweekly is well tolerated and the observed overall and complete response rates are promising

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Análise do rastreamento oportuno da sífilis no pré-natal de baixo risco

Este estudo teve como objetivo analisar a oferta oportuna do rastreamento da sífilis durante a gestação, no primeiro e terceiro trimestre. Trata-se de um estudo de abordagem quantitativa, transversal e descritivo, realizado com base em 41 registros de gestantes acompanhadas no Pré-natal de baixo risco da Unidade Básica de Saúde União, entre junho de 2016 e junho de 2017. Observou-se que os enfermeiros solicitaram mais frequentemente o Teste Rápido – TR em 65,9% e o exame de VDRL em 46,3%, no primeiro trimestre, enquanto no terceiro trimestre os médicos solicitaram o TR em 26,8% e VDRL em 63,4%. Os TR apresentaram-se reagentes em 4,88% no primeiro trimestre, enquanto o VDRL apresentou-se regente em 2,44% neste mesmo período e, em 4,88% no terceiro trimestre. Constataram-se fragilidades no acompanhamento gestacional e oferta não oportuna do rastreamento, indicando a necessidade de investimento em estratégias de promoção e educação em saúde para combater o problema

Características do cuidado em saúde mental em um CAPS na perspectiva dos profissionais Characteristics of mental health care in a CAPS from the perspective of the professionals

Neste estudo qualitativo, subprojeto da pesquisa "Avaliação dos CAPSs da região sul do Brasil", temos o objetivo de conhecer as características do cuidado em saúde mental oferecido por um centro de atenção psicossocial (CAPS) na perspectiva de seus profissionais. A coleta de dados foi realizada por meio de entrevistas individuais. Utilizou-se a análise temática, emergindo dos dados três temáticas. Neste artigo, destacamos a temática intitulada 'caracterização do cuidado em saúde mental prestado pelos profissionais do CAPS'. As características do cuidado em saúde mental advindas das entrevistas foram autonomia do usuário, que, juntamente com a questão da alta do serviço, deve ser mais desenvolvida; atendimento centrado especificamente na doença como herança do tratamento hospitalar; e preocupação da equipe com a implementação de práticas psicossociais inclusivas e cidadãs.<br>In this qualitative study, a sub-project of the "Evaluation of CAPSs in Southern Brazil" research project, the goal is to get to know the characteristics of mental health care offered by a psychosocial care center (CAPS) in view of its professionals. Data collection was conducted through individual interviews. Thematic analysis was used, and three themes stemmed from the data. In this article, we highlight the theme titled 'characterization of the mental health care provided by the CAPS professionals.' The characteristics of mental health care noticed in the interviews were user autonomy, which, together with the issue of discharge from the service, should be further developed; care focused specifically on the disease as a legacy of hospital care; and the team's concern with the implementation of inclusive psychosocial practices