Access to treatment for oral cancer in the regions of the Regional Management Collegiate of Campinas, SP

Orientador: Marcelo de Castro MeneghimDissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O estudo teve como objetivo avaliar o acesso dos pacientes com diagnóstico de câncer bucal aos serviços de referência em oncologia, na região do Colegiado de Gestão Regional (CGR) de Campinas. Tratou-se de estudo epidemiológico, com desenho observacional, transversal com a análise secundária de dados. Na região do CGR Campinas estão habilitados 07 Centros de Especialidades odontológicas ¿ CEOs, com cobertura de 1.596.728 habitantes. A Regulação para os serviços de referência é feita pelo Núcleo de Regulação do Departamento Regional de Saúde de Campinas - DRS7. Foram analisados todos os casos de câncer bucal diagnosticados de forma positiva nessa região, no ano de 2011, no total de 26 indivíduos. Na primeira etapa foi realizado um levantamento exploratório dos relatórios gerenciais dos CEOs e dos Sistemas de Informações dos municípios e região. Na fase seguinte, foi realizado revisão dos prontuários junto aos serviços para levantamento de dados demográficos, fatores de risco, tipo histológico da lesão, local da lesão, data da biópsia, data do diagnóstico, data do encaminhamento para referência e da primeira consulta em serviço de referência, início, término e modalidade do tratamento (cirurgia, radioterapia ou quimioterapia) e a análise dos desfechos dos casos. Os resultados mostraram que dos 19 indivíduos selecionados com câncer bucal e localizados, 18 eram do gênero masculino (94,7%), 15,8% tinham entre 20 ¿ 49 anos de idade, 36,8% entre 50 ¿ 59 anos e 47,4% acima de 60 anos. O tempo decorrido entre a detecção da lesão e a confirmação do diagnóstico foi, em média, menor do que 30 dias para 78,9%. A regulação do encaminhamento se deu de forma prioritária pelo município (47,4%). Em 94,7% dos indivíduos, os CEOs não tem o registro do tempo decorrido entre diagnóstico e primeira consulta em serviço especializado. Os CEOs também não tem contrarreferência, pois desconhecem a situação atual de 52,6% dos pacientes Pode-se concluir que há necessidade de melhor acompanhamento dos pacientes diagnosticados com câncer bucal na região do CGR Campinas quanto ao acesso aos serviços de referência em oncologiaAbstract: The study aimed to evaluate the access of patients with oral cancer diagnosis to reference services for oncology treatment in the regions of the Regional Management Collegiate ("Colegiado de Gestão Regional - CGR") of Campinas. This was an epidemiological study with an observational, cross-sectional design and secondary data analysis. In the CGR Campinas region, there are 07 authorized oncology centers (CEOs) providing 1,596,728 inhabitants with coverage. The reference services are regulated by the DRS7 Regulation Nucleus. The sample consisted of a survey of a total of 26 cases of oral cancer diagnosed as positive in this region in the year 2011. In the first stage, an exploratory survey was conducted of the management reports of the CEOs, and Information Systems of the Municipalities and Region. In the second stage, a survey was conducted of demographic data, risk factors, histologic type of the lesion, site, and biopsy data of the lesion, diagnostic data, date of referral to the reference center and first consultation at the reference center, date of beginning and conclusion of treatment and treatment modality (surgery, radiotherapy or chemotherapy) and analysis of outcomes of the cases. The results showed that of the 19 cases of oral cancer selected, 18 were of the male gender (94.7%), with 15.8% were between 20 ¿ 49 years of age, 36.8% between 50 ¿ 59 years and 47,4% over 60 years old. The mean time elapsed between detection of the lesion and confirmation of diagnosis was fewer than 30 days for 78,9% of patients. Regulation of referral by the municipality occurred in a prioritized manner (47,4%). The majority of CEOs had no record of the time elapsed between diagnosis and first consultation. The CEOs had no counter-reference, because when the outcome of the case was considered, this had been ignored in 52.6% of cases. It could be concluded that there is need for better monitoring of patients diagnosed with oral cancer in the region of Campinas CGR regarding acess to referral services in oncologyMestradoOdontologia em Saude ColetivaMestra em Odontologia em Saúde Coletiv

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora