Estudo de sobrevida livre de doença em mulheres com câncer de mama atendidas em serviço privado de Florianópolis

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências, Tecnologias e Saúde. Medicina (Araranguá).Introdução: O câncer de mama apresenta incidência crescente e altos índices de morbimortalidade. O estudo de sobrevida livre de doença tem contribuído para a compreensão do seu comportamento e dos fatores prognósticos. Objetivo: Analisar a sobrevida livre de doença e fatores prognósticos em mulheres com câncer de mama atendidas em um serviço privado de saúde. Métodos: Estudo de coorte aberta com população dinâmica de mulheres com diagnóstico de câncer de mama não metastático atendidas no período de 2010 a 2021. Foram coletados dados demográficos e clínicos. A análise estatística foi descritiva, bivariada e de sobrevida pelo método de Kaplan-Meier (teste log-rank). Resultados: Foi identificada sobrevida livre de doença em 96 meses de 57,7% (IC95%: 38,2-73,1). As variáveis significativas associadas ao prognóstico da doença foram estádio clínico, status hormonal de estrogênio, modalidade cirúrgica da mama e quimioterapia. Na avaliação tumoral foram constatados piores índices de sobrevida livre de doença em estádio III e status de estrogênio negativo. Nas condutas terapêuticas, cirurgia conservadora da mama e quimioterapia adjuvante relacionaram-se a taxas maiores. Conclusão: Características tumorais e clínicas são importantes para a compreensão da sobrevida livre de doença e identificação de perfis de risco para recidiva, dada a escassez de pesquisas relacionadas ao tema na população brasileira

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Medidas biométricas da região nasal de recém-nascidos para desenvolvimento de modelo de protetor nasal: estudo transversal*

Objetivo: Correlacionar las medidas biométricas de la región nasal de neonatos prematuros y a término y ofrecer parámetros para un modelo de protector nasal. Método: Se realizó un estudio descriptivo de corte transversal en unidades de internación conjunta de cuidados intermediarios e intensivos neonatales de un hospital de Maceió, Alagoas, con 300 recién nacidos, divididos en dos grupos: 150 a término y 150 prematuros. Para las mediciones biométricas se utilizaron datos de la historia neonatal y 1.200 fotografías digitales. Resultados: Los grupos eran homogéneos en cuanto a sexo, peso y longitud del recién nacido. Las medidas de la anchura nasal, la distancia del ala de la nariz a la línea media del subtabique, lado derecho e izquierdo, la longitud y la anchura del subtabique, el área de las fosas nasales derecha e izquierda, la longitud del tabique nasal lado derecho e izquierdo eran diferentes cuando se compararon en los grupos según la edad gestacional, y en los rangos de peso: peso muy bajo, peso bajo y peso adecuado para la edad gestacional (p<0,05). Conclusión: Los datos obtenidos brindan parámetros para la creación de un protector nasal para recién nacidos que utilizan prongs, considerando los aspectos anatómicos.Objective: To correlate the biometric measurements of the nasal area of premature and term newborns to provide parameters for a nasal protector model. Method: A crosssectional descriptive study, carried out in the neonatal joint accommodation, intermediate and intensive care units of a hospital in Maceio, Alagoas, with a total of 300 newborns, divided into two groups: 150 term and 150 premature. Neonatal history data and 1200 digital photographs were used for biometric measurements. Results: The groups were homogeneous regarding gender, weight and length of the newborn. The measurements of nasal width, distance from the wing of the nose to the right and left columella midline, right and left nasal introitus area, length of the right and left nasal dorsum were different when compared in groups according to gestational age and weight ranges - very low weight, low weight and appropriate weight for gestational age (p<0.05). Conclusion: The data obtained provide parameters for creating a nasal protector for newborns using prongs, considering anatomical aspects.Objetivo: Correlacionar as medidas biométricas da região nasal de recém-nascidos prematuros e a termo e fornecer parâmetros para um modelo de protetor nasal. Método: Estudo descritivo de corte transversal, realizado nas unidades de alojamento conjunto, cuidados intermediários e intensivos neonatais de um hospital de Maceió, Alagoas, com 300 recém-nascidos, divididos em dois grupos: 150 a termo e 150 prematuros. Utilizaram-se dados da história neonatal e 1200 fotografias digitais para as medidas biométricas. Resultados: Os grupos foram homogêneos quanto ao sexo, peso e comprimento do recém-nascido. As medidas de largura nasal, distância da asa do nariz à linha média columelar direita e esquerda, comprimento e largura da columela, área do introito nasal direita e esquerda, comprimento do dorso nasal direito e esquerdo apresentaram-se diferentes quando comparadas em grupos de acordo com a idade gestacional, e quanto às faixas de peso - muito baixo peso, baixo peso e peso adequado a idade gestacional (p<0,05). Conclusão: Os dados obtidos fornecem parâmetros para criação de protetor nasal para recém-nascidos em uso de pronga, considerando aspectos anatômicos

Continuous positive pressure on aircraft in neonates: care provided by the nursing team

ABSTRACT Objective: to describe the nursing care of the neonate in continuous positive airway pressure (CPAP) with prong analyzing them in the light of the systematization of nursing care / process. Method: Descriptive research, qualitative approach. We interviewed 30 nursing professionals from the neonatal intensive and intermediate care units of a school hospital in Maceió / Alagoas, from August / 2016 to January / 2017, through a semi-structured interview, in the light of Bardin's content analysis. Results: Although unit nurses are aware of the use of CPAP and the care associated with this therapy, mid-level professionals still find it difficult to systematize systematized knowledge about the system. The tripod's correlation between CPAP, the formation of nasal lesions and the assistance provided was highlighted. Conclusion: It is necessary to carry out training, such as raising the awareness of professionals about the importance of keeping records up to date and applying protocols