Sistema de pré-qualificação de marcas e produtos médico-hospitalares do Inca

Para garantir a segurança no tratamento dos pacientes e aos profissionais de saúde, foi criado o “Sistema especial para pré-qualificação de marcas e produtos” para participação em licitações de materiais hospitalares no Inca, devido à peculiaridade do paciente oncológicoNúmero de páginas: 04 p.InovaçãoIniciativa premiada no 12º Concurso Inovação na Gestão Pública Federal sob responsabilidade de Luiz Eduardo Tinoco Werneck. Ações premiadas no 12º Concurso Inovação na Gestão Pública Federal – 200

Como promover e trabalhar em parceria

No Brasil, os procedimentos médicos de alta complexidade absorvem elevada parcela dos recursos do SUS, particularmente nas especialidades de nefrologia e oncologia, ao mesmo tempo em que atingem uma parcela reduzida da população. A partir da percepção das dificuldades existentes, foi elaborado e implantado um programa de controle e avaliação em oncologia (atendimento ambulatorial em quimioterapia e radioterapia), mediante parceria entre o Inca/Pró-onco e o SUS Campos. Com a iniciativa observou-se uma redução de mais de 50% nos gastos com quimioterapia, cujos custos exibem uma tendência progressiva ao declínio. Os gastos com radioterapia exibem padrão variável, visto que os mecanismos de controle e avaliação ainda se encontram em implantação. Houve ganho em qualidade das indicações terapêuticas. Desenvolveu-se maior motivação entre os auditores e revisores, que passaram a dispor de instrumentos mais eficazes para realizar seu trabalho. Melhorou o entendimento e a organização do fluxo de informações entre o SUS-Campos e os prestadores. Os prestadores reconheceram a necessidade de melhor organizar seus serviços e de iniciar um registro adequado dos casos. Ocorreu uma melhoria generalizada na qualidade das informações. O SUS-Campos tomou a iniciativa de utilizar o registro de mortalidade e de programar outros tipos de registro que possam favorecer o controle e avaliação em oncologia. Passou a ser desenvolvida uma metodologia de bases realistas para aplicar-se a um programa de controle e avaliação em oncologia. Surgiu a possibilidade de acompanhamento dos casos e de avaliação dos resultados dos tratamentos aplicadosNúmero de páginas: 2 p.InovaçãoIniciativa premiada no 1º Concurso Inovação na Gestão Pública Federal sob responsabilidade de Maria Inez Pordeus Gadelha. Ações premiadas no 1º Concurso Inovação na Gestão Pública Federal – 1996. Áreas temáticas: parcerias e gestão participativ

Trend analysis of the quality indicators for the Brazilian cervical cancer screening programme by region and state from 2006 to 2013

Quality indicators for the Brazilian cervical cancer screening programme can provide a perspective on its effectiveness in Brazilian macro-regions and states. The aim of this study was to perform a trend analysis of the cervical cancer screening program's quality indicators, according to Brazilian regions and states, from 2006 to 2013.(undefined)info:eu-repo/semantics/publishedVersio

Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil : a cross-sectional study

BACKGROUND: The success of HPV vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population. The aim of this study was to assess the level of awareness and knowledge of human papillomavirus (HPV) infection, cervical cancer prevention, vaccines, and factors associated with HPV awareness among young women after birth of the first child. METHODS: This analysis is part of a cross-sectional study carried out at Hospital Maternidade Leonor Mendes de Barros, a large public maternity hospital in Sao Paulo. Primiparous women (15-24 years) who gave birth in that maternity hospital were included. A questionnaire that included questions concerning knowledge of HPV, cervical cancer, and vaccines was applied. To estimate the association of HPV awareness with selected factors, prevalence ratios (PR) were estimated using a generalized linear model (GLM). RESULTS: Three hundred and one primiparous women were included; 37% of them reported that they "had ever heard about HPV", but only 19% and 7%, respectively, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer. Seventy-four percent of interviewees mentioned the preventive character of vaccines and all participants affirmed that they would accept HPV vaccination after delivery. In the multivariate analysis, only increasing age (P for trend = 0.021) and previous STI (P < 0.001) were factors independently associated with HPV awareness ("had ever heard about HPV"). CONCLUSIONS: This survey indicated that knowledge about the association between HPV and cervical cancer among primiparous young women is low. Therefore, these young low-income primiparous women could benefit greatly from educational interventions to encourage primary and secondary cervical cancer prevention programs.This study was supported by a research grant from Department of Immunization, Vaccines and Biologicals, World Health Organization (ref: V20-181-13). The authors are grateful to Dr M.T. Aguado for helpful discussions. We are also grateful to Dr Corintio Mariani Neto for the unconditional support provided during field work and to nurses from Hospital Maternidade Leonor Mendes de Barros

Smoking among morbidly obese patients

<p>Abstract</p> <p>Background</p> <p>Smokers usually have a lower Body Mass Index (BMI) when compared to non-smokers. Such a relationship, however, has not been fully studied in obese and morbidly obese patients. The objective of this study was to evaluate the relationship between smoking and BMI among obese and morbidly obese subjects.</p> <p>Methods</p> <p>In a case-control study design, 1022 individuals of both genders, 18-65 years of age, were recruited and grouped according to their smoking status (smokers, ex-smokers, and non-smokers) and nutritional state according to BMI (normal weight, overweight, obese, and morbidly obese).</p> <p>Results</p> <p>No significant differences were detected in the four BMI groups with respect to smoking status. However, there was a trend towards a higher frequency of smokers among the overweight, obese, and morbidly obese subjects compared to normal weight individuals (p = 0.078). In a logistic regression, after adjusting for potential confounders, morbidly obese subjects had an adjusted OR of 2.25 (95% CI, 1.52-3.34; p < 0.001) to be a smoker when compared to normal weight individuals.</p> <p>Discussion</p> <p>In this sample, while the frequency of smokers diminished in normal weight subjects as the BMI increased, such a trend was reversed in overweight, obese, and morbidly obese patients. In the latter group, the prevalence of smokers was significantly higher compared to the other groups. A patient with morbid obesity had a 2-fold increased risk of becoming a smoker. We speculate that these finding could be a consequence of various overlapping risk behaviors because these patients also are generally less physically active and prefer a less healthy diet, in addition to having a greater alcohol intake in relation to their counterparts. The external validity of these findings must be confirmed.</p

Mammography-based screening program: preliminary results from a first 2-year round in a Brazilian region using mobile and fixed units

RLH, TBS and ALF made substantial contributions to the conception and design of the article, the acquisition, analysis and interpretation of the data, and drafting of the article. ECM, JSCM and NB made substantial contributions to the conception and design of the study.Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among women worldwide. The use of mobile mammography units to offer screening to women living in remote areas is a rational strategy to increase the number of women examined. This study aimed to evaluate results from the first 2 years of a government-organized mammography screening program implemented with a mobile unit (MU) and a fixed unit (FU) in a rural county in Brazil. The program offered breast cancer screening to women living in Barretos and the surrounding area. Methods: Based on epidemiologic data, 54 238 women, aged 40 to 69 years, were eligible for breast cancer screening. The study included women examined from April 1, 2003 to March 31, 2005. The chi-square test and Bonferroni correction analyses were used to evaluate the frequencies of tumors and the importance of clinical parameters and tumor characteristics. Significance was set at p < 0.05. Results: Overall, 17 964 women underwent mammography. This represented 33.1% of eligible women in the area. A mean of 18.6 and 26.3 women per day were examined in the FU and MU, respectively. Seventy six patients were diagnosed with breast cancer (41 (54%) in the MU). This represented 4.2 cases of breast cancer per 1000 examinations. The number of cancers detected was significantly higher in women aged 60 to 69 years than in those aged 50 to 59 years (p < 0.001) or 40 to 49 years (p < 0.001). No difference was observed between women aged 40 to 49 years and those aged 50 to 59 years (p = 0.164). The proportion of tumors in the early (EC 0 and EC I) and advanced (CS III and CS IV) stages of development were 43.4% and 15.8%, respectively. Conclusions: Preliminary results indicate that this mammography screening program is feasible for implementation in a rural Brazilian territory and favor program continuation

Development and validation of a simple questionnaire for the identification of hereditary breast cancer in primary care

<p>Abstract</p> <p>Background</p> <p>Breast cancer is a significant public health problem worldwide and the development of tools to identify individuals at-risk for hereditary breast cancer syndromes, where specific interventions can be proposed to reduce risk, has become increasingly relevant. A previous study in Southern Brazil has shown that a family history suggestive of these syndromes may be prevalent at the primary care level. Development of a simple and sensitive instrument, easily applicable in primary care units, would be particularly helpful in underserved communities in which identification and referral of high-risk individuals is difficult.</p> <p>Methods</p> <p>A simple 7-question instrument about family history of breast, ovarian and colorectal cancer, FHS-7, was developed to screen for individuals with an increased risk for hereditary breast cancer syndromes. FHS-7 was applied to 9218 women during routine visits to primary care units in Southern Brazil. Two consecutive samples of 885 women and 910 women who answered positively to at least one question and negatively to all questions were included, respectively. The sensitivity, specificity and positive and negative predictive values were determined.</p> <p>Results</p> <p>Of the 885 women reporting a positive family history, 211 (23.8%; CI95%: 21.5–26.2) had a pedigree suggestive of a hereditary breast and/or breast and colorectal cancer syndrome. Using as cut point one positive answer, the sensitivity and specificity of the instrument were 87.6% and 56.4%, respectively. Concordance between answers in two different applications was given by a intra-class correlation (ICC) of 0.84 for at least one positive answer. Temporal stability of the instrument was adequate (ICC = 0.65).</p> <p>Conclusion</p> <p>A simple instrument for the identification of the most common hereditary breast cancer syndrome phenotypes, showing good specificity and temporal stability was developed and could be used as a screening tool in primary care to refer at-risk individuals for genetic evaluations.</p

Aquisição de equipamentos médicos de grande porte no modelo Turnkey

A iniciativa consiste na mudança da forma de aquisição de equipamento médico de grande porte (EMGP), pela adoção da contratação em regime Turnkey. O objetivo principal foi reduzir o tempo de instalação dos EMGP para diagnóstico e tratamento, assegurando a oferta de serviços de saúde à população de forma mais ágil. A iniciativa foi motivada pela necessidade de cumprir prazos e custos planejados nos projetos de aquisição e instalação de novos EMGP, o que não vinha sendo alcançado dentro do modelo tradicional. O objetivo foi alcançado, bem como objetivos secundários, incluindo: não admitir equipamento novo encaixotado na instituição; assegurar a execução dos projetos de aquisição de EMGP dentro dos custos aprovados e programados, e alcançar custos globais menores com a seleção da melhor oferta global. O projeto foi incorporado na instituição como um programa e vem sendo compartilhado com outros órgãos.Número de páginas: 18 p.Administração PúblicaLicitação. ComprasSaúdeIniciativa premiada no 19º Concurso Inovação na Gestão Pública Federal sob responsabilidade de Luis Claudio Gonzaga Donadio, Analista de C&TRonnie Reus Schroeder. Ações premiadas no 19º Concurso Inovação na Gestão Pública Federal – 2014. Área temática: melhoria dos processos de trabalh