CRIANÇAS E ADOLESCENTES EM CUIDADOS PALIATIVOS ONCOLÓGICOS: a intervenção do serviço social junto as suas famílias

Este artigo tem o objetivo de discutir e subsidiar as ações profissionais do assistente social nos serviços que atendem crianças e adolescentes em cuidados paliativos oncológicos, assim como suas famílias, e contribuir para o ensino e pesquisa na área. Baseado em uma revisão bibliográfica, o artigo parte dos seguintes eixos de análise: atuação do Serviço Social na saúde e atenção às famílias, particularidades do câncer infantil e cuidados paliativos. Busca entender quem são essas famílias e como os impactos trazidos pelo sistema econômico atual afetam suas relações nesse momento do tratamento. Diante desse panorama, coloca desafios para o Serviço Social, como a integração de políticas sociais para a intervenção na área da saúde e o fortalecimento do Projeto Ético Político Profissional em práticas interdisciplinares. A partir disso, propõe, nas conclusões, algumas atividades para intervenção profissional.Palavras-chave: Serviço Social, família, câncer pediátrico, cuidados paliativos.CHILDREN AND ADOLESCENTS IN CANCER PALLIATIVE CARE: social work intervention within their familiesAbstract: This study aims to discuss and support the activities of social workers in social services that assist children and adolescents with cancer, as well as their families, in palliative care. It also aims to contribute to teaching and research in the area. Based on a literature review, the article discusses the following lines of analysis: the role of Social Work and health care for families, features of childhood cancer and palliative care and how illness and death in childhood represent a tragedy for their families. It is necessary to understand who these families are, and how the impacts brought by the current economic system affect the relations among it´s members during the time of treatment. Considering this background, there are challenges for Social Work, such as the integration of social policies for intervention in health care as well as streightening Social Workers Professional activity and also putting into practice Political and Ethical Projects in interdisciplinary practices. Considering these highlights some activities for professional intervention were proposed in the end of the paper.Keywords: Social Work, family, pediatric cancer, palliative care

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

CRIANÇAS E ADOLESCENTES EM CUIDADOS PALIATIVOS ONCOLÓGICOS: a intervenção do serviço social junto as suas famílias

Este artigo tem o objetivo de discutir e subsidiar as ações profissionais do assistente social nos serviços que atendem crianças e adolescentes em cuidados paliativos oncológicos, assim como suas famílias, e contribuir para o ensino e pesquisa na área. Baseado em uma revisão bibliográfica, o artigo parte dos seguintes eixos de análise: atuação do Serviço Social na saúde e atenção às famílias, particularidades do câncer infantil e cuidados paliativos. Busca entender quem são essas famílias e como os impactos trazidos pelo sistema econômico atual afetam suas relações nesse momento do tratamento. Diante desse panorama, coloca desafios para o Serviço Social, como a integração de políticas sociais para a intervenção na área da saúde e o fortalecimento do Projeto Ético Político Profissional em práticas interdisciplinares. A partir disso, propõe, nas conclusões, algumas atividades para intervenção profissional.Palavras-chave: Serviço Social, família, câncer pediátrico, cuidados paliativos.CHILDREN AND ADOLESCENTS IN CANCER PALLIATIVE CARE: social work intervention within their familiesAbstract: This study aims to discuss and support the activities of social workers in social services that assist children and adolescents with cancer, as well as their families, in palliative care. It also aims to contribute to teaching and research in the area. Based on a literature review, the article discusses the following lines of analysis: the role of Social Work and health care for families, features of childhood cancer and palliative care and how illness and death in childhood represent a tragedy for their families. It is necessary to understand who these families are, and how the impacts brought by the current economic system affect the relations among it´s members during the time of treatment. Considering this background, there are challenges for Social Work, such as the integration of social policies for intervention in health care as well as streightening Social Workers Professional activity and also putting into practice Political and Ethical Projects in interdisciplinary practices. Considering these highlights some activities for professional intervention were proposed in the end of the paper.Keywords: Social Work, family, pediatric cancer, palliative care

CRIANÇAS E ADOLESCENTES EM CUIDADOS PALIATIVOS ONCOLÓGICOS: a intervenção do Serviço Social junto às suas famílias

This study aims to discuss and support the activities of social workers in social services that assist children and adolescents with cancer, as well as their families, in palliative care. It also aims to contribute to teaching and research in the area. Based on a literature review, the article discusses the following lines of analysis: the role of Social Work and health care for families, features of childhood cancer and palliative care and how illness and death in childhood represent a tragedy for their families. It is necessary to understand who these families are, and how the impacts brought by the current economic system affect the relations among it ́s members during the time of treatment. Considering this background, there are challenges for Social Work, such as the integration of social policies for intervention in health care as well as streightening Social Workers Professional activity and also putting into practice Political and Ethical Projects in interdisciplinary practices. Considering these highlights some activities for professional intervention were proposed in the end of the paper

A multicenter study of oral sarcomas in Brazil

Aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil. Materials and methodsA cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods. ResultsFrom 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling localised pain and bleeding at a mean evolution time of 5.14 months (range <1-156 months). The lesions were mostly observed in the mandible (90 cases; 45%), with a mean tumour size of 3.4 cm (range of 0.3-15 cm). Radiographically, the lesions presented a radiolucent aspect showing cortical bone destruction and ill-defined limits. ConclusionsOral sarcomas are rare lesions with more than 50 described subtypes. Osteosarcomas and Kaposi's sarcomas were the main sarcomas of the oral cavity in Brazil261435

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used