M?todos de rastreamento do c?ncer de mama : conhecimento, atitude e pr?tica de mulheres idosas

Made available in DSpace on 2015-04-14T13:54:14Z (GMT). No. of bitstreams: 1 462450.pdf: 2269851 bytes, checksum: 3a35e5c19fe227adb9bdf18df2681eaa (MD5) Previous issue date: 2014-07-28Introduction: The demographic alterations which the population undergoes had as consequence a noteworthy number of cases of noncommunicable chronic diseases, among them cancer and, in elderly women, breast cancer is highlighted. Objective: To evaluate knowledge, attitude and practice of breast cancer screening methods among elderly women in the municipality of Jo?o Pessoa PB. Method: Home survey of evaluative type: Knowledge, Attitude and Practice , cross-sectional and quantitative study carried out with 322 elderly women aged 60 or above, registered in the Family Health Units (USF) of Jo?o Pessoa. Data were collected from July 2013 to February 2014, by using the structured interview questionnaire. For analyzing the results, the variables were described as absolute and relative frequencies. In order to evaluate the association among the variables, Pearson?s chi-squared test or Fisher?s exact test were used, being established the significance level of 5% (p?0,05). The analyses were fulfilled by means of the statistical program Statistical Package for the Social Sciences, version 21.0. The research project met the criteria established in the Resolution n?. 466/2012, that rules the research involving human subjects, being approved by the Research Ethics Committee of the Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Statement n? 290.083; CAAE 12147813.0.0000.5336. Results: Most of the elderly women present appropriate knowledge, attitude and practice concerning breast selfexamination (BSE), appropriate attitude for the clinical examination and appropriate knowledge and attitude for the mammography. There was no meaningful association among the socio-demographic data and the adequacy of knowledge, attitude and practice for both the breast self-examination and the clinical examination. For the mammography, meaningful association in regard to knowledge was observed in the following variables: age group (p=0,036) and education level (p=0,022); attitude, in education level (p<0,001) and with practice, in the age group (p=0,0023) and education level (p=0,004). With reference to the association among the knowledge and attitude variables with the practice of the breast selfexamination, the study revealed significance for the attitude observing that most of the elderly women who have appropriate attitude also have appropriate practice for the mentioned examination. In relation to the association among the knowledge and attitude variables with the practice of the clinical breast examination and the mammography, there was no significance. Conclusions: Taking into account the results, it is perceived the need for educational actions in health, theoretical and practical, related mainly to the strengthening of knowledge and practice adequacy of the breast cancer tracking methods in elderly women by highlighting the clinical breast examination and the mammography. It is still necessary that the health teams of the Family Health Units enhance the active search of elderly women for the disease screening as well as the awareness of the competent organizations so as to include in the national program of control and combat of breast cancer the elderly women aged from 70, once it is a serious problem of public health that causes great suffering for the women in all phases of life and, especially, in such a sublime phase as the old age.Introdu??o: As altera??es demogr?ficas por que passa a popula??o trouxeram como consequ?ncia um n?mero significante de casos de doen?as cr?nicas n?o transmiss?veis, entre elas o c?ncer e, nas mulheres idosas, apresenta destaque o c?ncer de mama. Objetivo: Avaliar o conhecimento, a atitude e a pr?tica dos m?todos de rastreamento do c?ncer de mama entre idosas do munic?pio de Jo?o Pessoa PB. M?todo: Inqu?rito domiciliar, do tipo avaliativo: Conhecimento, Atitude e Pr?tica CAP, transversal e quantitativo, realizado junto a 322 idosas com idade igual ou superior a 60 anos, cadastradas nas Unidades de Sa?de da Fam?lia de Jo?o Pessoa. Os dados foram coletados no per?odo de julho de 2013 a fevereiro de 2014, utilizando-se formul?rio de entrevista estruturada. Para a an?lise dos resultados, as vari?veis foram descritas por frequ?ncias absolutas e relativas. Para avaliar a associa??o entre as vari?veis, foram aplicados os testes qui-quadrado de Pearson ou exato de Fisher, sendo estabelecido o n?vel de signific?ncia de 5% (p?0,05). As an?lises foram realizadas atrav?s do programa estat?stico Statistical Package for the Social Sciences, vers?o 21.0. O projeto de pesquisa atendeu aos crit?rios estabelecidos na Resolu??o n?. 466/2012, que regulamenta a pesquisa envolvendo seres humanos, sendo aprovado pelo Comit? de ?tica e Pesquisa da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, parecer n? 290.083; CAAE 12147813.0.0000.5336. Resultados: A maioria das idosas apresenta conhecimento, atitude e pr?tica adequados para o autoexame das mamas, atitude adequada para o exame cl?nico e conhecimento e atitude adequados para a mamografia. N?o houve associa??o significativa entre os dados sociodemogr?ficos e adequabilidade do conhecimento, da atitude e da pr?tica para o autoexame e exame cl?nico das mamas. Para a mamografia, observou-se associa??o significativa quanto ao conhecimento, nas vari?veis faixas et?rias (p=0,036) e escolaridade (p=0,022); com a atitude, na escolaridade (p<0,001) e com a pr?tica, na faixa et?ria (p=0,0023) e escolaridade (p=0,004).Quanto ? associa??o entre as vari?veis conhecimento e atitude com a pr?tica do autoexame das mamas, o estudo revelou signific?ncia para a atitude, observando-se que a grande maioria das idosas que possuem atitude adequada, tamb?m possuem pr?tica adequada para o referido exame. Em rela??o ? associa??o entre as vari?veis conhecimento e atitude com a pr?tica do exame cl?nico das mamas e da mamografia, n?o houve signific?ncia. Conclus?es: Diante dos resultados, percebe-se a necessidade de a??es educativas em sa?de, te?ricas e pr?ticas, voltadas principalmente para o fortalecimento da adequabilidade do conhecimento e da pr?tica dos m?todos de rastreamento do c?ncer de mama em mulheres idosas, destacando-se o exame cl?nico das mamas e a mamografia. Necess?rio, ainda, que as equipes de sa?de das Unidades de Sa?de Fam?lia incrementem a busca ativa de idosas para o rastreamento da doen?a, bem como a sensibiliza??o dos ?rg?os competentes no sentido de incluir no programa nacional de controle e combate ao c?ncer de mama idosas a partir dos 70 anos, tendo em vista se tratar de grave problema de sa?de p?blica, que imprime grande sofrimento para as mulheres em todas as fases da vida e, de modo especial, em fase t?o sublime como a idosa

Métodos de rastreamento do câncer de mama: conhecimento, atitude e prática de mulheres idosas

Introdução: As alterações demográficas por que passa a população trouxeram como consequência um número significante de casos de doenças crônicas não transmissíveis, entre elas o câncer e, nas mulheres idosas, apresenta destaque o câncer de mama.Objetivo: Avaliar o conhecimento, a atitude e a prática dos métodos de rastreamento do câncer de mama entre idosas do município de João Pessoa – PB.Método: Inquérito domiciliar, do tipo avaliativo: Conhecimento, Atitude e Prática – CAP, transversal e quantitativo, realizado junto a 322 idosas com idade igual ou superior a 60 anos, cadastradas nas Unidades de Saúde da Família de João Pessoa. Os dados foram coletados no período de julho de 2013 a fevereiro de 2014, utilizando-se formulário de entrevista estruturada. Para a análise dos resultados, as variáveis foram descritas por frequências absolutas e relativas. Para avaliar a associação entre as variáveis, foram aplicados os testes qui-quadrado de Pearson ou exato de Fisher, sendo estabelecido o nível de significância de 5% (p£0,05). As análises foram realizadas através do programa estatístico Statistical Package for the Social Sciences, versão 21. 0. O projeto de pesquisa atendeu aos critérios estabelecidos na Resolução nº. 466/2012, que regulamenta a pesquisa envolvendo seres humanos, sendo aprovado pelo Comitê de Ética e Pesquisa da Pontifícia Universidade Católica do Rio Grande do Sul, parecer n° 290. 083; CAAE 12147813. 0. 0000. 5336.Resultados: A maioria das idosas apresenta conhecimento, atitude e prática adequados para o autoexame das mamas, atitude adequada para o exame clínico e conhecimento e atitude adequados para a mamografia. Não houve associação significativa entre os dados sociodemográficos e adequabilidade do conhecimento, da atitude e da prática para o autoexame e exame clínico das mamas. Para a mamografia, observou-se associação significativa quanto ao conhecimento, nas variáveis faixas etárias (p=0,036) e escolaridade (p=0,022); com a atitude, na escolaridade (p<0,001) e com a prática, na faixa etária (p=0,0023) e escolaridade (p=0,004). Quanto à associação entre as variáveis conhecimento e atitude com a prática do autoexame das mamas, o estudo revelou significância para a atitude, observando-se que a grande maioria das idosas que possuem atitude adequada, também possuem prática adequada para o referido exame. Em relação à associação entre as variáveis conhecimento e atitude com a prática do exame clínico das mamas e da mamografia, não houve significância.Conclusões: Diante dos resultados, percebe-se a necessidade de ações educativas em saúde, teóricas e práticas, voltadas principalmente para o fortalecimento da adequabilidade do conhecimento e da prática dos métodos de rastreamento do câncer de mama em mulheres idosas, destacando-se o exame clínico das mamas e a mamografia. Necessário, ainda, que as equipes de saúde das Unidades de Saúde Família incrementem a busca ativa de idosas para o rastreamento da doença, bem como a sensibilização dos órgãos competentes no sentido de incluir no programa nacional de controle e combate ao câncer de mama idosas a partir dos 70 anos, tendo em vista se tratar de grave problema de saúde pública, que imprime grande sofrimento para as mulheres em todas as fases da vida e, de modo especial, em fase tão sublime como a idosa.Introduction: The demographic alterations which the population undergoes had as consequence a noteworthy number of cases of noncommunicable chronic diseases, among them cancer and, in elderly women, breast cancer is highlighted.Objective: To evaluate knowledge, attitude and practice of breast cancer screening methods among elderly women in the municipality of João Pessoa – PB.Method: Home survey of evaluative type: Knowledge, Attitude and Practice – , cross-sectional and quantitative study carried out with 322 elderly women aged 60 or above, registered in the Family Health Units (USF) of João Pessoa. Data were collected from July 2013 to February 2014, by using the structured interview questionnaire. For analyzing the results, the variables were described as absolute and relative frequencies. In order to evaluate the association among the variables, Pearson´s chi-squared test or Fisher´s exact test were used, being established the significance level of 5% (p£0,05). The analyses were fulfilled by means of the statistical program Statistical Package for the Social Sciences, version 21. 0. The research project met the criteria established in the Resolution nº. 466/2012, that rules the research involving human subjects, being approved by the Research Ethics Committee of the Pontifícia Universidade Católica do Rio Grande do Sul, Statement n° 290. 083; CAAE 12147813. 0. 0000. 5336.Results: Most of the elderly women present appropriate knowledge, attitude and practice concerning breast selfexamination (BSE), appropriate attitude for the clinical examination and appropriate knowledge and attitude for the mammography. There was no meaningful association among the socio-demographic data and the adequacy of knowledge, attitude and practice for both the breast self-examination and the clinical examination. For the mammography, meaningful association in regard to knowledge was observed in the following variables: age group (p=0,036) and education level (p=0,022); attitude, in education level (p<0,001) and with practice, in the age group (p=0,0023) and education level (p=0,004). With reference to the association among the knowledge and attitude variables with the practice of the breast selfexamination, the study revealed significance for the attitude observing that most of the elderly women who have appropriate attitude also have appropriate practice for the mentioned examination. In relation to the association among the knowledge and attitude variables with the practice of the clinical breast examination and the mammography, there was no significance.Conclusions: Taking into account the results, it is perceived the need for educational actions in health, theoretical and practical, related mainly to the strengthening of knowledge and practice adequacy of the breast cancer tracking methods in elderly women by highlighting the clinical breast examination and the mammography. It is still necessary that the health teams of the Family Health Units enhance the active search of elderly women for the disease screening as well as the awareness of the competent organizations so as to include in the national program of control and combat of breast cancer the elderly women aged from 70, once it is a serious problem of public health that causes great suffering for the women in all phases of life and, especially, in such a sublime phase as the old age

Increased activity of the renin-angiotensin and sympathetic nervous systems is required for regulation of the blood pressure in rats fed a low-protein diet.

Previous studies have shown that postweaning protein restriction induces changes in the sympathetic nervous system in rats, leading to alterations in cardiovascular parameters. In addition, the renin?angiotensin system is also affected in these animals. Here, we hypothesized that adjustments in the interaction between the RAS and SNS underlie the cardiovascular adaptations observed in rats fed a low-protein diet. Thus, we evaluated the alterations in the mean arterial pressure (MAP) and heart rate of Fisher rats fed a protein-deficient diet before and after systemic administration of the angiotensin-converting enzyme inhibitor enalapril and the angiotensin II (Ang II) type 1 (AT1) receptor antagonist losartan alone or in combination with the ?1-adrenergic receptor antagonist prazosin. Administration of enalapril or losartan decreased the MAP only of rats under protein restriction. Prazosin injection after the infusion of losartan caused a further decrease in the MAP of malnourished rats. In contrast, only the administrationof prazosin elicited a reductionin theMAPof control animals.Whenthe sequence of administrationof the antagonistswasinverted, infusion of prazosin inanimals fedthe standard or the low-protein diet induced a reduction in the MAP that was further decreased by the subsequent injection of losartan. Importantly, in both protocols the responses ofmalnourished animals to losartan were markedly greater when compared with the control group. Moreover, these animals presented lower levels of circulatingAng II and a reduced responsiveness to Ang II. In contrast, the expression of AT1 receptors in the aorta ofmalnourished animals was increased. Thus, our data suggest that the renin?angiotensin system is an important factor supporting blood pressure in rats fed a low-protein diet and that the sympathetic nervous system activity in these animals is under strong influence of Ang II acting via AT1 receptors