INFLAMMATORY BREAST NEOPLASMS: A SYSTEMATIC REVIEW

Overview: Inflammatory Breast Cancer (IBC) is a rare and very aggressive type of cancer that tends to develop at a younger age, compared with other subtypes of breast cancer. Because a distinct lump may not be noticeable, correct diagnosis takes longer and, therefore, successful treatment may hinder a patient’s prognostics. This study aims to conduct a systematic review of research articles on IBC. Methods: This is a systematic review of studies in the PubMed database to April 2013, which fit the eligibility criterion of “Inflammatory Breast Neoplasms” (MeSH Terms), filtered by Languages (English OR Portuguese OR Spanish). Findings: Of the 119studies identified, 25 complied with the eligibility criterion for the disease, diagnostics, treatment and prognostics. Final Considerations :Despite methodological differences, findings evidence that although IBC presents particular features (lower survival rate and worse prognostics than most types of breast cancer), very few studies examine its epidemiology and specific risk factors in depth and use any other therapeutic approaches than those commonly used for other breast cancer subtypes. Therefore, further investigation of the disease’s aggressiveness is still necessary

Genética do Câncer Hereditário

Atualmente, o câncer é a doença que mais causa mortes no mundo. Devido a isso, ele tem sido alvo de inúmeras pesquisas, entre as quais se descobriu sua relação com a hereditariedade. Sabe-se que o câncer decorre de alterações em oncogenes, em genes pertencentes ao grupo supressor tumoral ou em genes do grupo que repara o DNA. Muitos desses genes já foram descobertos, identificados e relacionados a certos tipos de câncer. Esses achados proporcionaram a utilização de novos métodos de diagnóstico e tratamento para diversos tipos de neoplasias. O aconselhamento genético para pacientes com suspeita de portar um gene mutante causador de algum tipo de câncer hereditário pode diminuir sua morbi-mortalidade e proporcionar uma melhoria em sua qualidade de vida. Este trabalho apresenta os principais tipos de câncer hereditário, assim como os genes responsáveis pelos respectivos cânceres e discute a melhor conduta a ser realizada para o paciente após a descoberta de um gene mutante

PREVALENCE OF MAJOR DEPRESSION IN PATIENTS WITH BREAST CANCER

Introduction: breast cancer is one of the main causes of death among women in Brazil and worldwide. The diagnosis of breast neoplasms usually represents an emotional burden, and it may lead to adjustment reactions and even be the trigger for affective disorders (mainly depression), anxiety or psychosis. The Beck Depression Inventory (BDI) is one of the most used mechanisms for the evaluation of depression in research and in clinics. Depression prevalence in patients with cancer varies from 3% to 55% among different studies. Methodological variation, different instruments to assess depression and different cut-off points for diagnosis contribute to the huge discrepancy in current findings. In general, the more specifically depression is defined and evaluated, the lower the rates of prevalence are reported. Many articles fail to demonstrate a statistical significance in the relationship between depression and cancer-specific factors. This suggests that risk factors for depression in those patients are more related to the patient as contextual variables and premorbid factors of personality – and not to the cancer or its treatment. Objective: to determine the prevalence of major depression in women with breast cancer. Methods: a cross-sectional study was conducted in women with breast cancer. The sample consisted of 51 patients who answered the Beck Depression Inventory (BDI). The presence of depression was considered in cases where the scores were above 20. A questionnaire with additional data about the patients such as age, marital status, ethnicity, education, family income, family history of depression and breast cancer, and cancer-related variables including staging, months since diagnosis, treatment modality, type of surgery, alopecia occurring were used. Descriptive analysis and test of association (chi-square) were conducted. Results: the prevalence of major depression was 5.9%, similar to that observed in community samples. Subsyndromal depressive symptoms had a score of 21.6% (BDI scores from 16 to 20). Chi-square test was conducted and showed no statistically significant relationship between the classification of BDI and the variables tested (characteristics related to patient and cancer-specific). This indicates that the isolated context of the variables does not influence the event of depression. Conclusion: the prevalence of major depression in women with breast neoplasms was 5.9%

Vulnerability and the bioethics through the experiences of illness

Background: Vulnerable people are relatively or absolutely incapable of protecting their own interests. Vulnerability is an anthropological attribute of human beings due to the simple fact of being alive. Brazilian society has long been established as a matter through the eyes of social scientists. In the name of it, the vulnerability in the doctor-patient context is now being a much-discussed issue. Purpose: This study aims to analyze the current studies regarding the insertion of vulnerability in the health issue, reflexively dealing with the ethical matters involved, as well as with the narratives’ insertion in this process. Methods: This article is based on data extracted from Scientific Electronic Library Online (Scielo) and on secondary data from textbooks about vulnerability, ethics, physician-patient relationship and narratives. Results and discussion: Doctors are faced with dilemmas in clinical practice: moral, ethical, legal, social, religious and economic. On these occasions, question their own values. By listening carefully to the stories of patients, health professionals broaden their perspectives, organize and integrate complex situations, which assists in conducting these difficult situations. Conclusion: Reflect the concept of vulnerability raises (re) think health practices, particularly in bringing to light the social experience of illness and hospitalization of the patient

The biopsychosocial processes in autism spectrum disorder

Abstract\ud \ud \ud \ud Background\ud \ud Autism is a disorder characterized by pervasive social and communicative impairments, repetitive and stereotyped behaviors and restricted interests. Its causes and effects have been researched from various neurocognitive theoretical perspectives and with the aid of neuroimaging technology. We aimed to describe biopsychosocial processes characteristic of the Autism Spectrum Disorders.\ud \ud \ud \ud Method\ud \ud Literature review using Medline and Scopus databases published between 2001 and 2011, with the keywords "autism", "theory of mind", "executive functions", "central coherence" and “fMRI”.\ud \ud \ud \ud Results\ud \ud The studies found were plotted and organized into tables and an explanatory diagram of the main findings was produced.\ud \ud \ud \ud Conclusions\ud \ud The most popular neurocognitive theories are still unable to fully explain the characteristics of the complications that autistic spectrum disorder causes to the quality of life of individuals living with autism. The association of clinical research and neuroimaging may contribute to a better understanding of the functioning of the brain affected by the disorder.This group received support from School of Medicine of ABC

Treatment delays among women with breast cancer in a low socio-economic status region in Brazil

Abstract Background Considering the inequalities and the areas of low socioeconomic status in Brazil, access to health services is a challenge and the delay between diagnosis and treatment represents an important factor of worse prognosis in patients with breast cancer. Herein, we describe the clinical and epidemiological profiles of women with breast cancer and evaluate their access to health services, as well as treatment delays, at a reference centre of the Cariri region, Ceará, Brazil. Methods This is a retrospective study that included 473 women treated with breast cancer between 2009 and 2011 at the Oncology Centre of the Cariri. Results The majority of these patients were aged between 40 and 69 years old (65.7%), without a completed high school degree (89.2%). They were married (62.9%) and were already diagnosed but had not yet been subjected to any previous treatment (77.8%). It was observed that 91.8% were referred from the public health service, and treatment was paid for by the public health service in 92.9% of the cases. The patients whose source of referral was the public system waited longer between diagnosis and the treatment initiation (p = 0.031; Mann–Whitney’s test), with a median waiting time of 71.5 days versus 39 days for those receiving referrals from private services. In addition, those with public referrals prior to diagnosis also experienced a longer waiting time between the first medical visit and treatment initiation (77 days vs. 37 days; p = 0.036; Mann–Whitney’s test), with the waiting time for the biopsy being an important factor in this delay. Conclusions Late diagnosis was often the result of inefficiency of the prevention policies coupled with difficulty accessing the public health network. It was commonly observed that, even after diagnosis, the patients needed to wait too long before entering the Oncology Service because of long waiting queues in the public health system

Pervasive Development Disorder- Not Otherwise Specified

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