Cistectomia Radical e o seu Impacto na Sexualidade Feminina: uma Revisão da Literatura

Objectivo: A cistectomia radical (CR) é considerada o “gold-standard” no tratamento curativo dos tumores vesicais músculo-invasivos localizados. Nas mulheres implica classicamente a remoção da bexiga e órgãos adjacentes: uretra, parede anterior da vagina,útero e anexos. Em relação à derivação urinária, as mais utilizadas são a neobexiga ortotópica e o conducto ileal. Tendo em conta o grande impacto físico e psicológico que esta cirurgia tem na vida das mulheres, nomeadamente a nível sexual, procedeu-se a uma revisão da literatura sobre o tema, com vista a caracterizar a disfunção sexual secundária a CR, bem como técnicas e tratamentos existentes para minimizar a sua incidência. Métodos: Realizou-se uma revisão bibliográfica da literatura publicada entre 2000 e 2008, com recurso à Medline®/PubMed®, sobre o impacto da cistectomia radical e diferentes derivações urinárias na vida sexual das mulheres tratadas. Resultados: A CR tem impacto negativo na sexualidade feminina. Tal é independente do tipo de derivação urinária utilizada, prendendo-se com factores como lesões nervosas e vasculares decorrentes da técnica cirúrgica empregue. Conclusões: A CR é uma cirurgia com grande impacto na sexualidade feminina. É possível, alterando a técnica cirúrgica, promover à diminuição da disfunção sexual feminina subsequente a CR

Frequency of LCT -13910C>T single nucleotide polymorphism associated with adult-type hypolactasia/lactase persistence among Brazilians of different ethnic groups

<p>Abstract</p> <p>Background</p> <p>Adult-type hypolactasia, the physiological decline of lactase some time after weaning, was previously associated with the LCT -13910C>T polymorphism worldwide except in Africa. Lactase non-persistence is the most common phenotype in humans, except in northwestern Europe with its long history of pastoralism and milking. We had previously shown association of LCT -13910C>T polymorphism with adult-type hypolactasia in Brazilians; thus, we assessed its frequency among different Brazilian ethnic groups.</p> <p>Methods</p> <p>We investigated the ethnicity-related frequency of this polymorphism in 567 Brazilians [mean age, 42.1 ± 16.8 years; 157 (27.7%) men]; 399 (70.4%) White, 50 (8.8%) Black, 65 (11.5%) Brown, and 53 (9.3%) Japanese-Brazilian. DNA was extracted from leukocytes; LCT -13910C>T polymorphism was analyzed by PCR-restriction fragment length polymorphism.</p> <p>Results</p> <p>Prevalence of the CC genotype associated with hypolactasia was similar (57%) among White and Brown groups; however, prevalence was higher among Blacks (80%) and those of Japanese descent (100%). Only 2 (4%) Blacks had TT genotype, and 8 (16%) had the CT genotype. Assuming an association between CC genotype and hypolactasia, and CT and TT genotypes with lactase persistence, 356 (62.8%) individuals had hypolactasia and 211 (37.2%) had lactase persistence. The White and Brown groups had the same hypolactasia prevalence (~57%); nevertheless, was 80% among Black individuals and 100% among Japanese-Brazilians (<it>P </it>< 0.01).</p> <p>Conclusion</p> <p>The lactase persistence allele, LCT -13910T, was found in about 43% of both White and Brown and 20% of the Black Brazilians, but was absent among all Japanese Brazilians studied.</p

Analysis of Nursing Dissertations and Theses on Mental Health, Brazil, 1979-2007

This bibliographic study analyzes scientific texts published in the CEPEn database in the mental health field (1979-2007). A total of 280 abstracts were investigated, of which 208 were Master’s theses. The individuals investigated in these studies were professionals (57), patients (50), and professors and/or students (18). Among the themes addressed between 2000 and 2007 were the following: Nursing Care in Mental Health (40), Perception in Mental Health (37); and Transversality in Mental Health Care (27). This study provided an overview of the scientific research produced in the mental health field in Brazilian nursing graduate programs. We expect this study to elicit reflections concerning mental health care practice and enable new approaches for nursing promoting health and the prevention of diseases in order to enable patients to recover their citizenship, autonomy and quality of life.Se trata de un estudio bibliográfico, con el objetivo de analizar los textos científicos divulgados en la base de datos CEPEn en el área de salud mental (1979-2007). El total de resúmenes estudiados fueron 280, de los cuales 208 eran disertaciones de maestría. Los sujetos que se destacaron fueron los profesionales (57) y pacientes (50). Entre las temáticas abordadas se evidenciaron (2000-2007): el Cuidado de Enfermería en Salud Mental (40) y la Percepción en Salud Mental (37). Este trabajo posibilitó obtener una visión panorámica sobre la producción científica en salud mental en los cursos de Posgraduación en Enfermería en Brasil. Esperamos que el estudio incentive la reflexión sobre las prácticas de cuidado en salud mental y posibilite nuevos abordajes en enfermería con el objetivo de promover la salud y prevenir daños, de forma a favorecer la ciudadanía, la autonomía y la calidad de vida de los sujetos envueltos.Trata-se de estudo bibliográfico, com o objetivo de analisar os textos científicos, divulgados na base de dados CEPEn, na área de saúde mental (1979-2007). O total de resumos estudados foi 280, dos quais 208 constituíam-se de dissertações de mestrado. Os sujeitos que se destacaram foram os profissionais (57) e pacientes (50). Dentre as temáticas abordadas evidenciaram-se (2000-2007): o cuidado de enfermagem em saúde mental (40) e a percepção em saúde mental (37). Este trabalho possibilitou visualização panorâmica acerca da produção científica em saúde mental nos cursos de pós-graduação em enfermagem, no Brasil. Espera-se, aqui, que o estudo suscite reflexões acerca das práticas de cuidado em saúde mental e possibilite novas abordagens em enfermagem, com vistas à promoção da saúde e prevenção de agravos que favoreçam a cidadania, autonomia e qualidade de vida dos sujeitos envolvidos

Avaliação de desempenho: discutindo a tecnologia para o planejamento e gestão de recursos humanos em saúde

Este ensaio apresenta o produto de reflexões e análises a partir do exame de opções conceituais inerentes às metodologias de avaliação de desempenho (AD) de profissionais e sua possibilidade de aplicação na área da saúde. Estabelece uma discussão conceitual para a área, articulando e integrando conhecimentos de campos distintos - o da saúde e o da administração pública. Promove a intersecção entre a gestão do trabalho em saúde no setor público e as técnicas da administração de pessoal. Pretende gerar novas análises e estudos que possibilitem uma releitura das práticas administrativas para avaliação de desempenho utilizadas nas organizações, adaptá-las para atender às especificidades do setor saúde

Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study

Background: Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil. / Methods: We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23–25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low–low, low–high, high–low, high–high), and the adiposity measures was examined using linear regression. / Results: There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: −1.49 (−2.29,−0.69); WC: −3.85 (−5.73,−1.97); WHR: −0.03 (−0.04,−0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,−1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (−0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men. / Conclusion: In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women