Cervical cancer screening coverage in a high-incidence region

OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program.METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used.RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2). Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5). A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening.CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease). Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.OBJETIVO Analisar a cobertura do programa de rastreamento do câncer do colo uterino em município com alta incidência da doença e os fatores relacionados à não adesão ao programa preventivo vigente.MÉTODOS Foi realizado estudo transversal, com base em inquérito domiciliar. A amostra foi composta por mulheres entre 25 e 59 anos de idade do município de Boa vista, RR, Brasil, com cobertura pelo programa de rastreamento do câncer do colo uterino. Foi utilizado o método de amostragem por conglomerado. A variável dependente foi a adesão ao programa de saúde da mulher, definida como a realização de pelo menos um teste de Papanicolaou nos 36 meses anteriores à data da entrevista; as variáveis explicativas foram extraídas a partir de informações individuais. Foi utilizado modelo linear generalizado.RESULTADOS Foram analisadas 603 mulheres, com idade média de 38,2 anos (DP = 10,2). Quinhentas e dezessete mulheres realizaram o exame, sendo a prevalência de realização, nos últimos três anos, de 85,7% (IC95% 82,5;88,5). Renda familiar per capita elevada e consulta médica recente associaram-se à menor taxa de não realização do exame na análise multivariada. O desconhecimento da doença, das causas e dos meios de prevenção correlacionou-se com a chance de não adesão ao rastreamento. Vinte por cento das mulheres relataram realização do exame em caráter oportunístico, e não rotineiro.CONCLUSÕES A cobertura informada é elevada, acima do recomendado para controle do câncer do colo uterino. O programa preventivo apresenta caráter oportunístico, sobretudo para as mulheres mais vulneráveis (com baixa renda e pouca informação sobre a doença). Estudos sobre a qualidade diagnóstica da citologia cervicovaginal e dos itinerários terapêuticos dos casos positivos são necessários para compreensão das barreiras para o controle do câncer do colo uterino

PERFIL EPIDEMIOLÓGICO DA GRAVIDEZ NA ADOLESCÊNCIA NAS MICRORREGIÕES DO ESTADO DO TOCANTINS DURANTE OS ANOS DE 2008 - 2018

Tocantins has a total population of approximately 1,383,445 inhabitants, about 10% of which are female adolescents. In this sense, attention should be focused on this class, since in recent years there has been an increase in the number of girls who become mothers during that phase. The aim of the study was to expose the numbers and suggest which factors may be related to teenage pregnancy. The data were taken from SINASC, from 2008 to 2018. It was found that of the 272983 live births, 64,623 were children of adolescent mothers. It was exposed that a gap in educational training may be related to this high rate, there was also a greater number of vaginal births as well as reduced prenatal consultations in the micro-regions with a deficient public health service, with emphasis on Jalapão. Investment in primary care is recommended, especially in the most affected micro-regions and in offering not only resources, but also special and structured care, providing better access to information and education for adolescents.Tocantins tiene una población total aproximada de 1.383.445 habitantes, de los cuales alrededor del 10% son mujeres adolescentes, en este sentido, la atención debe estar enfocada en esta clase, ya que en los últimos años se ha registrado un aumento en el número de niñas que se convierten en madres durante esa fase. El objetivo del estudio fue exponer las cifras y sugerir qué factores pueden estar relacionados con el embarazo adolescente. Los datos fueron tomados del SINASC, de 2008 a 2018. Se encontró que de los 272983 nacidos vivos, 64,623 fueron hijos de madres adolescentes. Se expuso que una brecha en la formación educativa puede estar relacionada con esta alta tasa, también hubo un mayor número de partos vaginales así como una reducción de las consultas prenatales en las microrregiones con un servicio público de salud deficiente, con énfasis en Jalapão. Se recomienda invertir en atención primaria, especialmente en las microrregiones más afectadas y en ofrecer no solo recursos, sino también atención especial y estructurada, brindando un mejor acceso a la información y educación de los adolescentes.O Tocantins apresenta população total de aproximadamente 1.383.445 habitantes sendo cerca de 10% são adolescentes do sexo feminino, nesse sentido, uma atenção deve ser voltada a essa classe já que nos últimos anos tem se observado os crescimentos na quantidade de meninas que se tornam mães durante essa fase. O objetivo do trabalho foi expor os números e sugerir quais fatores podem estar relacionados com a gravidez na adolescência. Os dados foram retirados do SINASC, no período de 2008 a 2018. Foi encontrado que dos 272983 nascidos vivos, 64.623 eram filhos   de   mães   adolescentes. Foi exposto que uma defasagem na formação educacional pode estar relacionada com esse índice elevado, evidenciou-se também um maior número de partos vaginais bem como reduzidas consultas pré-natais nas microrregiões com serviço público de saúde deficitário, com destaque para o Jalapão. É recomendado um investimento na atenção básica, principalmente nas microrregiões mais afetadas e na oferta não apenas de recursos, mas de atenção especial e estruturada, proporcionando melhor acesso à informação e instrução das adolescentes

Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study

INTRODUCTION: Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW). METHODS/PRINCIPAL FINDINGS: Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54%) were between 20-29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503) reported more than one malaria episode and most malaria episodes (84.5%, 846/1001) were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively). The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19-0.95]; p = 0.037) and among those women who reported higher antenatal care (ANC) attendance (OR, 0.32 [95% CI, 0.15-0.70]; p = 0.005). CONCLUSION: This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance

Câncer de pele: uma revisão de literatura

Skin cancer is caused by the abnormal and uncontrolled growth of the cells that make up the skin. These cells are arranged to form layers and, depending on which ones are affected, the different types of cancer are defined. This article aims to review skin cancer. This is an integrative review using the VHL, SciELO, LILACS and PubMed as databases over the last 5 years. 252 articles on the topic were evaluated with an emphasis on a synthesis of the most recent knowledge and greater scientific consistency. It is concluded that skin cancer requires great attention, from prevention to final diagnosis.O câncer de pele é provocado pelo crescimento anormal e descontrolado das células que compõem a pele. Essas células se dispõem formando camadas e, de acordo com as que forem afetadas, são definidos os diferentes tipos de câncer. Este artigo tem por objetivo revisar sobre o câncer de pele. Trata-se de uma revisão integrativa utilizando como base de dados a BVS, a SciELO, o LILACS e o PubMed, nos últimos 5 anos. Foram avaliados 252 artigos sobre o tema com ênfase em uma síntese dos conhecimentos mais recentes e de maior consistência científica. Conclui-se que o câncer de pele requer grande atenção, desde sua prevenção até o diagnóstico final

Abordagens inovadoras no tratamento da mielomeningocele: uma revisão da literatura atual

Mielomeningocele, a severe form of open spina bifida, is a congenital malformation of the central nervous system. Characterized by the exposure of the spinal cord and meninges due to a defect in neural tube closure during fetal development, the condition presents various neurological and medical complications throughout life. Treatment includes early closure of the defect to prevent infections and further damage to the spinal cord, along with a multidisciplinary approach to managing complications such as hydrocephalus, urological dysfunction, and musculoskeletal issues. Advances such as fetal surgery offer new perspectives, though they require further studies to validate their broad effectiveness. Folic acid supplementation is crucial in spina bifida prevention, underscoring the importance of maternal health. Economic and ethical considerations highlight the need for robust health policies to support these complex interventions.A mielomeningocele, uma forma grave de espinha bífida aberta, é uma malformação congênita do sistema nervoso central. Caracterizada pela exposição da medula espinhal e meninges devido a um defeito no fechamento do tubo neural durante o desenvolvimento fetal, a condição apresenta diversas complicações neurológicas e médicas ao longo da vida. O tratamento inclui o fechamento precoce do defeito para prevenir infecções e danos adicionais à medula, além de uma abordagem multidisciplinar para gerenciar complicações como hidrocefalia, disfunção urológica e problemas musculoesqueléticos. Avanços como a cirurgia fetal oferecem novas perspectivas, embora exijam mais estudos para validar sua eficácia ampla. A suplementação com ácido fólico é crucial na prevenção da espinha bífida, destacando a importância da saúde materna. Considerações econômicas e éticas ressaltam a necessidade de políticas de saúde robustas para apoiar essas intervenções complexas

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ