Shorter delay to treatment by integrated diagnostic services and NGO-provided support among breast cancer patients in two Brazilian referral centres

Background: The diagnosis of breast cancer requires a complicated series of diagnostic exams. The present study addressed the delay of patients who used publicly and privately financed diagnostic services. Non-governmental organizations (NGOs) donated diagnostic mammograms and biopsies.Design and Methods: Data from 304 patients were obtained from two Brazilian referral centres. In one referral centre (FAP), diagnostic mammography, clinic-histopathological exam and immunohistochemistry were outsourced, whereas in the other centre (HNL), these services were integrated. Cox regression, Kaplan-Meier analysis and non-parametric tests were used to compare variables and time intervals.Results: If diagnostic mammography was financed privately and covered by private health insurance, the likelihood of a delay of >90 days between the first medical visit and the initiation of treatment decreased 2.15-fold (95%CI: 1.06- 4.36; p=0.033) and 4.44-fold (95%CI: 1.58-12.46; p=0.004), respectively. If the clinic-histopathological exam was outsourced (FAP) and publicly or privately financed, the median time between diagnostic mammography and the diagnostic result was 53 and 65 days in the integrated (HNL) and outsourced public system, compared to 29 days in the outsourced private system (p<0.050). The median time between the first medical visit and the diagnostic results of patients who were supported by NGOs, who financed their diagnostic services privately, and who used exclusively public diagnostic services was, respectively, 28.0, 48.5 and 77.5 days (p<0.050).Conclusion: Patients who used privately financed health services had shorter delays. Compared to outsourcing, the integration of the publicly financed clinic- histopathological exam diminished the delay. The support of patients by NGOs accelerated patient flow

A prevalência de suicídio em idosos da região nordeste: Um estudo ecológico The prevalence of suicide in elderly people from the northeast region: An ecological study

 O suicídio na população idosa aumentou de maneira alarmante o mundo. De acordo com a OMS, os números de suicídio são elevados em pessoas com idade acima de 70 anos em quase todas as regiões do planeta. Um estudo realizado com 530 idosos atendidos pela Estratégia Saúde da Família constatou que 15,7% dos idosos apresentavam risco de suicídio.  Semelhantemente, outros autores destacam que mais de dois terços dos idosos procuraram atendimento na ESF trinta dias antes de se suicidar. O objetivo deste estudo é analisar a prevalência de suicídios em idosos na região Nordeste do Brasil. Trata-se de um estudo descritivo, ecológico de abordagem quantitativa sobre prevalência de suicídio no Nordeste brasileiro entre os anos de 2012 a 2016. Entre os cinco anos estudados, ocorreram 2120 casos de suicídio em idosos apenas na região Nordeste do país. Houve um aumento de 1,6 % entre os anos de 2015 e 2016. O suicídio em idosos deve ser visto com atenção, pois se trata de uma população que está convivendo com questões sociais que não são debatidas em nosso cotidiano.