4 research outputs found
Avaliação das visitas domiciliárias por estudantes e pelas famÃlias: uma visão de quem as realiza e de quem as recebe
A Faculdade de Medicina de MarÃlia (Famema) é reconhecida por favorecer o ensino baseado na prática e centrado no estudante. Os estudantes são inseridos em Unidades de Saúde da FamÃlia (USF), onde interagem com a comunidade no desenvolvimento de ações - reflexões - ações, por meio da realização de visitas domiciliárias durante os dois primeiros anos dos cursos de Enfermagem e Medicina. Tais visitas são consideradas ferramentas para a compreensão e o cuidado em necessidades de saúde da famÃlia. Dessa maneira, elas têm por objetivo englobar os aspectos sociais, psicológicos e econômicos do indivÃduo. Objetivo: Esta pesquisa avalia comparativamente a opinião dos estudantes e das famÃlias que realizaram e receberam visitas domiciliárias. Métodos: Trata-se de um estudo descritivo e quantitativo que informa a opinião das famÃlias e dos estudantes a respeito das visitas domiciliárias. Conclusões: As famÃlias e os estudantes consideram importante a valorização e o aprimoramento da prática, visando à construção humanizada do processo saúde-doença, incentivando, desde o princÃpio, a formação acadêmica e o vÃnculo integral entre profissional da saúde e paciente
Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series
Background: Patients with brain metastases (BM) live longer due to improved diagnosis and oncologic treatments. The association of volumetric modulated arc therapy (VMAT) and image-guided radiation therapy (IGRT) with brain radiosurgery (SRS) allows complex dose distributions and faster treatment delivery to multiple lesions.
Materials and methods: This study is a retrospective analysis of SRS for brain metastasis using VMAT. The primary endpoints were local disease-free survival (LDFS) and overall survival (OS). The secondary outcomes were intracranial disease-free survival (IDFS) and meningeal disease-free survival (MDFS).
Results: The average number of treated lesions was 5.79 (range: 2–20) per treatment in a total of 113 patients. The mean prescribed dose was 18 Gy (range: 12–24 Gy). The median LDFS was 46 months. The LDFS in 6, 12, and 24 months was for 86%, 79%, and 63%, respectively. Moreover, brain progression occurred in 50 patients. The median overall survival was 47 months. The OS in 75%, 69%, and 61% patients was 6, 12, and 24 months, respectively. IDFS was 6 and 24 months in 35% and 14% patients, respectively. The mean MDFS was 62 months; it was 6 and 24 months for 87% and 83% of patients. Acute severe toxicity was relatively rare. During follow-up, the rates of radionecrosis and neurocognitive impairment were low (10%).
Conclusion: The use of VMAT–SRS for multiple BM was feasible, effective, and associated with low treatment-related toxicity rates. Thus, treatment with VMAT is a safe technique to plan to achieve local control without toxicity.