Avaliação dos custos relacionados às medidas preventivas e ao tratamento do câncer de colo de útero no Brasil / Evaluation of the costs related to preventive measures and treatment of cervical cancer in Brazil

Introdução: O câncer de colo uterino é um importante problema de saúde pública, é o terceiro câncer mais frequente em mulheres e a quarta causa de mortalidade no Brasil. Dentre todos os tipos de câncer, o câncer do colo do útero é o que apresenta um dos mais altos potenciais de prevenção e cura, se diagnosticado e tratado precocemente. O exame de rastreio deste câncer é considerado umas das estratégicas públicas mais efetivas, seguras e de baixo custo para detecção precoce. O crescimento nos gastos para controle da doença acentua sua importância como problema de saúde pública, o tratamento do câncer do colo do útero representa um grande impacto na economia brasileira. Objetivos: Avaliar as características clínico-epidemiológicas e os custos das internações hospitalares e procedimentos realizados no SUS por câncer de colo uterino no período de 2012 a 2017. Métodos: Trata-se de um estudo transversal, descritivo, com informações coletadas a partir do banco de dados TabNet- DataSUS, utilizando o CID-10 “C53.0- Neoplasia maligna do colo uterino”. Foram incluídas todas as faixas etárias que necessitaram de internação hospitalar, registrados no período de 2012 a 2017, em todos os Regiões brasileiras. Analisou-se os custos, caráter de internação e mortalidade. NO período do estudo a cobertura da vacina predominou no sexo feminino (86%), semelhante a estudos realizados nos EUA. A colpocitologia teve uma média de cobertura em torno de 28,55%. Em relação aos custos gastos com rastreamento e diagnóstico de câncer de colo uterino, obtivemos resultados inferiores em relação a outros países. A taxa média de internações hospitalares por ano foi de 3,54 internações/10.000 mulheres expostas. A idade média com maior número de internação foi 40 a 59 anos, com aproximadamente 6 dias de internação. Do ponto de vista econômico, o valor médio gasto por cada internação foi de R$ 1683,33. Os gastos com serviços hospitalares foram quatro vezes maiores do que o gasto com serviços de profissionais da área da saúde.  Das pacientes internadas, 13.358 pacientes evoluíram para o óbito em 5 anos. Conclusão: Conclui-se, portanto, que ocorreu aumento significativo no número das internações hospitalares por câncer de colo uterino, e que a taxa de cobertura do exame colpocitológico está muito baixa, necessitando-se campanhas de estímulos à realização do mesmo

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Diazepam causes sedative rather than anxiolytic effects in C57BL/6J mice

Diazepam has been broadly accepted as an anxiolytic drug and is often used as a positive control in behavioral experiments with mice. However, as opposed to this general assumption, the effect of diazepam on mouse behavior can be considered rather controversial from an evidence point of view. Here we revisit this issue by studying the effect of diazepam on a benchmark task in the preclinical anxiety literature: the elevated plus maze. We evaluated the minute-by-minute time-course of the diazepam effect along the 10 min of the task at three different doses (0.5, 1 and 2 mg/kg i.p. 30 min before the task) in female and male C57BL/6J mice. Furthermore, we contrasted the effects of diazepam with those of a selective serotoninergic reuptake inhibitor (paroxetine, 10 mg/kg i.p. 1 h before the task). Diazepam had no anxiolytic effect at any of the tested doses, and, at the highest dose, it impaired locomotor activity, likely due to sedation. Noteworthy, our results held true when examining male and female mice separately, when only examining the first 5 min of the task, and when animals were subjected to one hour of restrain-induced stress prior to diazepam treatment. In contrast, paroxetine significantly reduced anxiety-like behavior without inducing sedative effects. Our results therefore suggest that preclinical studies for screening new anxiolytic drugs should be cautious with diazepam use as a potential positive control.These authors contributed equally: Marina Pádua-Reis and Diana Aline Nôga.</p

Reduced Vesicular Acetylcholine Transporter favors antidepressant behaviors and modulates serotonin and dopamine in female mouse brain.

Depression is extremely harmful to modern society. Despite its complex spectrum of symptoms, previous studies have mostly focused on the monaminergic system in search of pharmacological targets. However, other neurotransmitter systems have also been linked to the pathophysiology of depression. In this study, we provide evidence for a role of the cholinergic system in depressive-like behavior of female mice. We evaluated mice knockdown for the vesicular acetylcholine transporter (VAChT KD mice), which have been previously shown to exhibit reduced cholinergic transmission. Animals were subjected to the tail suspension and marble burying tests, classical paradigms to assess depressive-like behaviors and to screen for novel antidepressant drugs. In addition, brain levels of serotonin and dopamine were measured by high performance liquid chromatography. We found that female homozygous VAChT KD mice spent less time immobile during tail suspension and buried less marbles, indicating a less depressive phenotype. These differences in behavior were reverted by central, but not peripheral, acetylcholinesterase inhibition. Moreover, female homozygous VAChT KD mice exhibited higher levels of dopamine and serotonin in the striatum, and increased dopamine in the hippocampus. Our study thus shows a connection between depressive-like behaviors and the cholinergic system, and that the latter interacts with the monoaminergic system

Dual task multimodal physical training in Alzheimer’s disease: effect on cognitive functions and muscle strength

The aim of this study was to evaluate the effects of dual task multimodal physical training (MPT) on the cognitive functions and muscle strength in older adults with Alzheimer’s disease. Participants were 19 subjects with AD in the mild and moderate stages, divided into training group (TG) and control group (CG). The TG performed dual task MPT for 12 weeks. Subjects were evaluated at the pre- and post-intervention moments. The Mini Mental State Examination (MMSE), Clock Drawing Test (CDT) and Frontal Assessment Battery (FAB) were used to assess cognition. For muscle strength, the Chair Lift and Sit Test (CLST) and Manual Grasp Force (MGF) were used. The Wilcoxon test was used to analyze pre and post intragroup moments. The TG showed a significant improvement in FAB and CLST (p≤0.05) and a tendency to improve the MMSE score (p≤0.08). The CG showed significant improvement in CLST (p≤0.05). Dual task MPT improves the frontal cognitive functions and lower limb muscle strength of older adults with AD

O Protagonismo Infantojuvenil nos Processos Educomunicativos

Neste volume “O protagonismo infantojuvenil nos processos educomunicativos”, reunimos 53 artigos que transitam sobre a temática do protagonismo infantojuvenil em diversas experiências e processos educomunicativos e para facilitar sua leitura e busca por temas de seu interesse, eles estão organizados em 8 capítulos que abordam a educomunicação a partir do fazer das crianças e da apropriação da produção midiática.&nbsp;Expressão artística, rádio, vídeo, jornalismo, cultura digital, redes sociais entre outros são os temas abordados pelos autores destes trabalhos. convidamos o leitor&nbsp;a mergulhar nesta jornada educomunicativa, vivendo e revivendo junto conosco essas experiências vividas por outros, refletindo em cada texto sobre como estamos, como evoluímos e como seguimos os passos daqueles que com sua ousadia, amor e luta elaboraram os fundamentos da educomunicação

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease