Eficácia dos exercícios para ombro nas complicações loco-regionais em mulheres submetidas a radioterapia para câncer de mama: ensaio clínico

OBJECTIVE: To investigate the effect of shoulder exercises during radiotherapy in relation to prevention of locoregional physical complications: limitation of range of motion (ROM) and functional capacity, arm circumference and scar tissue adhesion. METHODS: Sixty-six women without shoulder ROM impairment following breast cancer surgery that included complete axillary dissection were allocated to one of two groups: 32 in the physical therapy group (PG) (52.7±10.2 years), who underwent an exercise program; and 34 in the control group (CG) (48±10.1 years). Shoulder ROM, upper-limb circumference and functional capacity and scar tissue adhesion were evaluated at the beginning and end of radiotherapy and six months after completing radiotherapy. RESULTS: The PG showed improvements in flexion and abduction ROM between the first and third evaluations (flexion from 164.77°±8.9° to 167.98°±9.5° and abduction from 168.56°±10.0° to 175.62°±10.2°), which was not observed in the CG (flexion from 167.06±06° to 165.16°±9.2° and abduction from 169.71°±10.1° to 169.53°±12.8°). There was a statistically significant increase in ROM in the PG in relation to the CG (flexion, p=0.02; and abduction, p=0.004). The circumference and functional capacity were similar between the groups and the frequency of scar tissue adhesion in the CG was twice that observed in the PG (48% versus 24%, p=0.04). CONCLUSIONS: These results suggest that shoulder exercises favor maintenance of flexion and abduction ROM of the shoulder and minimize the incidence of scar tissue adhesion in women undergoing radiotherapy for breast cancer treatment.OBJETIVO: Verificar o efeito da realização de exercícios para o ombro durante a radioterapia na prevenção de complicações físicas loco-regionais: limitação da amplitude de movimento (ADM) e da capacidade funcional, circunferência do braço e aderência cicatricial. MÉTODOS: Sessenta e seis mulheres sem comprometimento de ADM de ombro no pós-operatório de cirurgia para câncer de mama com dissecção axilar completa foram alocadas em dois grupos, sendo 32 no grupo de fisioterapia (GF) (52,7±10,2 anos), o qual foi submetido a um programa de exercícios, e 34 no grupo controle (GC) (48±10,1 anos). A ADM do ombro, a circunferência e capacidade funcional dos membros superiores e a aderência cicatricial foram avaliados no início e no final da radioterapia e seis meses após seu término. RESULTADOS: O GF apresentou melhora da ADM de flexão e abdução entre a primeira e terceira avaliação (Flexão: de 164,77°±8,9° para 167,98°±9,5° e Abdução: 168,56°±10° para 175,62°±10,2°), o que não se observou no GC (Flexão: 167,06°±6° para 165,16°±9,2° e Abdução: 169,71°±10,1° para 169,53°±12,8°), demonstrando uma melhora significativa do GF em relação do GC (Flexão: p=0,02 e Abdução: p=0,004). A circunferência e a capacidade funcional foram similares entre os grupos e a frequência de aderência cicatricial no GC foi o dobro daquela observada no GF (48% e 24%, p=0,04). CONCLUSÕES: Esses resultados sugerem que exercícios para o ombro favorecem a manutenção da ADM de flexão e abdução de ombro e minimizam a incidência de aderência cicatricial em mulheres submetidas à radioterapia para tratamento por câncer de mama.13614

PREVALENCE OF CHAGAS DISEASE AMONG BLOOD DONOR CANDIDATES IN TRIANGULO MINEIRO, MINAS GERAIS STATE, BRAZIL

Despite public health campaigns and epidemiological surveillance activities, Chagas disease remains a major health problem in Latin America. According to data from the World Health Organization, there are approximately 7-8 million people infected with Trypanosoma cruzi worldwide, a large percentage of which in Latin America. This study aims to examine the serological profile of blood donors in blood banks of Hemominas hematology center, in the town of Ituiutaba, Minas Gerais State, Brazil. The study sample consisted of 53,941 blood donors, which were grouped according to gender and age. Sample collections were performed from January 1991 to December 2011, and 277 donors (0.5%) were considered serologically ineligible due to Chagas disease. Analysis of data showed no significant difference between genders. As for age, the highest proportion of ineligible donors was from 40 to 49 years (30%), and there was a positive correlation between increasing age and the percentage of patients seropositive for Chagas disease. Therefore, adopting strategies that allow the safe identification of donors with positive serology for Chagas disease is essential to reduce or eliminate indeterminate serological results

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Stress among nurses: an examination of salivary cortisol levels on work and day off

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)The present study evaluates the use of salivary cortisol concentration as a physiological index of the stress level among nurses on their work day and day off and correlates it with the questionnaire used to measure occupational stress in nurses (Inventario de Estresse em Enfermeiros IEE). This is a comparative, cross-sectional descriptive study in which sociodemographic data, IEE results and salivary cortisol levels were used. Fifty-seven nurses participated in the study (80.7% females and a mean age of 37.1 years old). The IEE average score was 124.5. The average cortisol level was 564.1 ng/m on work day and 354.1 ng/mL on day off. Nurses who had double workdays presented high values of salivary cortisol during the work day (638.1 ng/mL). In conclusion, salivary cortisol identified the nurses' stress level, and differences were found between a work day and day off. On the nurses' day off, their salivary cortisol levels and stress scores were lower.47511871194Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES