O fisioterapeuta na equipe de atenção básica prisional: Os desafios da saúde pública no cárcere / The physiotherapist in the prison basic care team: The challenges of public health in the jail

Introdução: A população privada de liberdade comumente enfrenta degradantes condições de encarceramento, o que favorece o aparecimento de problemas de saúde. O sistema prisional possui alguns fatores que desfavorecem a reinserção social, tais como: superlotação, violência intramuros, falta de infraestrutura e recursos humanos especializados. Objetivo: Realizar uma revisão narrativa da literatura sobre a relevância do fisioterapeuta no âmbito penitenciário como integrante da equipe de atenção básica prisional e os desafios deste na execução da saúde no cárcere. Metodologia: A busca narrativa foi realizada nas bases de dados PubMed, Scielo e LILACS. Os critérios de inclusão estabelecidos para escolher os estudos foram: artigos na íntegra dos quais explanassem na discussão sobre a fisioterapia nas Unidades Penais, como também da atuação da equipe multiprofissional no cárcere para efetivar a saúde pública; publicações indexadas nos últimos cinco anos; e artigos publicados nos idiomas português e inglês. Sendo excluídos os artigos em duplicidade nas bases de dados utilizadas. Resultados e Discussão: Foram elegidas 02 publicações. Constatou-se que o aglomerado populacional nas celas carcerárias predispõe agravos de condições de saúde. As unidades penais têm a atenção em saúde dos prisioneiros pautadas na prevenção e promoção da saúde, com referência da equipe de Estratégia Saúde da Família. Identificou-se que o cárcere tem restrições e dificuldades que podem afetar a biomecânica do movimento. Conclusão: Tais circunstâncias demonstram avanços nas políticas de saúde para as pessoas privadas de liberdade. Contudo, torna-se pertinente novos estudos sobre a fisioterapia nas prisões, uma vez que, nenhuma pesquisa apresentou com clareza a atuação do fisioterapeuta na equipe de atenção básica prisional

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery