Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.

INTRODUCTION: The emergence of the COVID-19 pandemic has served as a call for enhanced global cooperation and a more robust pandemic preparedness and response framework. As a result of this pressing demand, dialogues were initiated to establish a pandemic treaty designed to foster a synchronized global strategy for addressing forthcoming health emergencies. In this review, we discussed the main obstacles to this treaty. RESULTS: Among several challenges facing the pandemic treaty, we highlighted (1) global cooperation and political will, (2) equity in access to resources and treatments, (3) sustainable financing, (4) compliance and enforcement mechanisms, (5) sovereignty concerns, and (6) data sharing and transparency. CONCLUSION: Navigating the hurdles facing the development of the pandemic treaty requires concerted efforts, diplomatic finesse, and a shared commitment to global solidarity. Addressing challenges in global cooperation, equitable access, transparency, compliance, financing, and sovereignty is essential for forging a comprehensive and effective framework for pandemic preparedness and response on the global stage.

Implementation of the Fast-track Protocol for Total Hip Arthroplasty in a Public Hospital in the State of São Paulo - Brazil.

Objective Evaluate the results of the implementation of the Fast Track Protocol (FTP), a medical practice based on scientific evidence, for elective total hip arthroplasty surgery, mainly comparing the National Average Hospital Admission Rate of 7.1 days. Methods 98 patients who underwent elective total hip arthroplasty surgery via the direct anterior approach, anterolateral approach and posterior approach were included in the FTP from December 2018 to March 2020, being followed up preoperatively, intraoperatively and immediately postoperatively. Results The average length of hospital stay was 2.8 days, being 2.1 days for the direct anterior approach, 3.0 days for the anterolateral access approach and 4.1 days for the posterior access approach. The average surgery time was 90 minutes, 19 (19.39%) of the patients were referred to the ICU in the postoperative period, however, none of them underwent surgery using the direct anterior approach. We had no cases of deep vein thrombosis (DVT), pulmonary embolism (PTE) or neurological injury, 19 (19.39%) patients had postoperative bleeding requiring dressing change, 4 (4.08%) needed blood transfusion, 2 (2.04%) patients had implant instability, 1 (1.02%) patient had a fracture during surgery and 1 (1.02%) patient died of cardiac complications. Conclusion FTP may be a viable alternative to reduce the length of stay and immediate postoperative complications for elective total hip arthroplasty surgery decreasing the length of stay of patients by 2 to 3 times when compared to the national average of 7.1 days.

Coronary Inflammation by Computed Tomography Pericoronary Fat Attenuation and Increased Cytokines in Young Male Anabolic Androgenic Steroid Users. / Inflamação Coronária Avaliada pela Atenuação de Gordura Pericoronária na Tomografia Computadorizada e Elevação de Citocinas em Usuários Jovens de Esteroides Anabólicos Androgênicos.

BACKGROUND: Anabolic androgenic steroid (AAS) abuse has been associated with coronary artery disease (CAD). Pericoronary fat attenuation (pFA) is a marker of coronary inflammation, which is key in the atherosclerotic process. OBJECTIVE: To evaluate pFA and inflammatory profile in AAS users. METHODS: Twenty strength-trained AAS users (AASU), 20 AAS nonusers (AASNU), and 10 sedentary controls (SC) were evaluated. Coronary inflammation was evaluated by mean pericoronary fat attenuation (mPFA) in the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex (LCx). Interleukin (IL)-1 (IL-1), IL-6, IL-10, and TNF-alpha were evaluated by optical density (OD) in a spectrophotometer with a 450 nm filter. P<0.05 indicated statistical significance. RESULTS: AASU had higher mPFA in the RCA (-65.87 [70.51-60.70] vs. -78.07 [83.66-72.87] vs.-78.46 [85.41-71.99] Hounsfield Units (HU), respectively, p<0.001) and mPFA in the LAD (-71.47 [76.40-66.61] vs. -79.32 [84.37-74.59] vs. -82.52 [88.44-75.81] HU, respectively, p=0.006) compared with AASNU and SC. mPFA in the LCx was not different between AASU, AASNU, and SC (-72.41 [77.17-70.37] vs. -80.13 [86.22-72.23] vs. -78.29 [80.63-72.29] HU, respectively, p=0.163). AASU compared with AASNU and SC, had higher IL-1, (0.975 [0.847-1.250] vs. 0.437 [0.311-0.565] vs. 0.530 [0.402-0.780] OD, respectively, p=0.002), IL-6 (1.195 [0.947-1.405] vs. 0.427 [0.377-0.577] vs. 0.605 [0.332-0.950] OD, p=0.005) and IL-10 (1.145 [0.920-1.292] vs. 0.477 [0.382-0.591] vs. 0.340 [0.316-0.560] OD, p<0.001). TNF-α was not different between the AASU, AASNU, and SC groups (0.520 [0.250-0.610] vs. 0.377 [0.261-0.548] vs. 0.350 [0.182-430]), respectively. CONCLUSION: Compared with ASSNU and controls, AASU have higher mPFA and higher systemic inflammatory cytokines profile suggesting that AAS may induce coronary atherosclerosis through coronary and systemic inflammation.

FUNDAMENTO: O uso abusivo de esteroides anabólicos androgênicos (EAA) tem sido associado à doença arterial coronariana (DAC). A atenuação de gordura pericoronária (AGp) é um marcador de inflamação coronária, a qual exerce um papel chave no processo aterosclerótico. OBJETIVO: Avaliar AGp e perfil inflamatório em usuários de EAA. MÉTODO: Vinte indivíduos que realizavam treinamento de força, usuários de EAA (UEAA), 20 não usuários de EAA (NUEAA), e 10 indivíduos sedentários controle (SC) foram avaliados. Inflamação coronária foi avaliada por atenuação de gordura pericoronária média (AGPm) artéria coronária direita (ACD), artéria descendente anterior esquerda (ADA) e artéria circunflexa (ACX). Interleucina (IL)-1 (IL-1), IL-6, IL-10, e TNF-alfa foram avaliados por densidade ótica (DO) em um espectrofotômetro com um filtro de 450 nm. Um p<0,05 indicou significância estatística. RESULTADOS: Os UEAA apresentaram maior AGPm na ACD [-65,87 (70,51-60,70) vs. -78,07 (83,66-72,87) vs.-78,46 (85,41-71,99] unidades Hounsfield (HU), respectivamente, p<0,001) e AGPm na ADA [-71,47 (76,40-66,610 vs. -79,32 (84,37-74,59) vs. -82,52 (88,44-75,81) HU, respectivamente, p=0,006) em comparação aos NUEAA e CS. A AGPm na ACX não foi diferente entre os grupos UEAA, NUEAA e CS [-72,41 (77,17-70,37) vs. -80,13 (86,22-72,23) vs. -78,29 (80,63-72,29) HU, respectivamente, p=0,163). Em comparação aos NUEAA e aos CS, o grupo UEAA apresentaram maiores níveis de IL-1 [0,975 (0,847-1,250) vs. 0,437 (0,311-0,565) vs. 0,530 (0,402-0,780) DO, respectivamente, p=0,002), IL-6 [1,195 (0,947-1,405) vs. 0,427 (0,377-0,577) vs. 0,605 (0,332-0,950) DO, p=0,005) e IL-10 [1,145 (0,920-1,292) vs. 0,477 (0,382-0,591) vs. 0,340 (0,316-0,560) DO, p<0,001]. TNF-α não foi diferente entre os grupos UEAA, NUEAA e CS [0,520 (0,250-0,610) vs. 0,377 (0.261-0,548) vs. 0,350 (0,182-430)]. CONCLUSÃO: Em comparação aos NUEAA e controles, os UEAA apresentam maior AGPm e maior perfil de citocinas inflamatórias sistêmicas, sugerindo que os EAA podem induzir aterosclerose por inflamação coronária e sistêmica.

Smoking induces increased apoptosis in osteoblasts: changes in bone matrix organic components.

Clinical studies demonstrate the impact of smoking on bone tissue fragility and higher incidence of fractures. However, it is not totally understood which physiological mechanisms could be involved in these events. Previously, we showed important changes in bone tissue components in experimental model of cigarette smoke (CS) exposure. CS exposure induces worsening in bone mineralization and a decrease in collagen type I deposition, leading to bone fragility. Considering that the majority of clinical studies described bone structural changes by radiographic images, in this study we performed analyses "in situ" using tissue samples from smokers, former smokers and non-smokers to better understand how the increase in inflammatory mediators induced by smoking exposure could interfere in bone cells activity leading bone structural changes. We observed increased levels of IL-1ß, IL-6 and TNF-α in bone tissue homogenates with a concomitant increase in osteoblast apoptosis in smokers and former smokers compared with non-smokers. Histological changes in both smokers and former smokers were characterized by reduction in collagen type I. Only in smokers, it was observed decrease in trabecular area, suggesting increased bone resorption and increase in collagen type V. These results showed that osteoblasts apoptosis in association with increased bone resorption leads bone structural changes in smokers.

Inflamação Coronária Avaliada pela Atenuação de Gordura Pericoronária na Tomografia Computadorizada e Elevação de Citocinas em Usuários Jovens de Esteroides Anabólicos Androgênicos / Coronary Inflammation by Computed Tomography Pericoronary Fat Attenuation and Increased Cytokines in Young Male Anabolic Androgenic Steroid Users

Resumo Fundamento O uso abusivo de esteroides anabólicos androgênicos (EAA) tem sido associado à doença arterial coronariana (DAC). A atenuação de gordura pericoronária (AGp) é um marcador de inflamação coronária, a qual exerce um papel chave no processo aterosclerótico. Objetivo Avaliar AGp e perfil inflamatório em usuários de EAA. Método Vinte indivíduos que realizavam treinamento de força, usuários de EAA (UEAA), 20 não usuários de EAA (NUEAA), e 10 indivíduos sedentários controle (SC) foram avaliados. Inflamação coronária foi avaliada por atenuação de gordura pericoronária média (AGPm) artéria coronária direita (ACD), artéria descendente anterior esquerda (ADA) e artéria circunflexa (ACX). Interleucina (IL)-1 (IL-1), IL-6, IL-10, e TNF-alfa foram avaliados por densidade ótica (DO) em um espectrofotômetro com um filtro de 450 nm. Um p<0,05 indicou significância estatística. Resultados Os UEAA apresentaram maior AGPm na ACD [-65,87 (70,51-60,70) vs. -78,07 (83,66-72,87) vs.-78,46 (85,41-71,99] unidades Hounsfield (HU), respectivamente, p<0,001) e AGPm na ADA [-71,47 (76,40-66,610 vs. -79,32 (84,37-74,59) vs. -82,52 (88,44-75,81) HU, respectivamente, p=0,006) em comparação aos NUEAA e CS. A AGPm na ACX não foi diferente entre os grupos UEAA, NUEAA e CS [-72,41 (77,17-70,37) vs. -80,13 (86,22-72,23) vs. -78,29 (80,63-72,29) HU, respectivamente, p=0,163). Em comparação aos NUEAA e aos CS, o grupo UEAA apresentaram maiores níveis de IL-1 [0,975 (0,847-1,250) vs. 0,437 (0,311-0,565) vs. 0,530 (0,402-0,780) DO, respectivamente, p=0,002), IL-6 [1,195 (0,947-1,405) vs. 0,427 (0,377-0,577) vs. 0,605 (0,332-0,950) DO, p=0,005) e IL-10 [1,145 (0,920-1,292) vs. 0,477 (0,382-0,591) vs. 0,340 (0,316-0,560) DO, p<0,001]. TNF-α não foi diferente entre os grupos UEAA, NUEAA e CS [0,520 (0,250-0,610) vs. 0,377 (0.261-0,548) vs. 0,350 (0,182-430)]. Conclusão Em comparação aos NUEAA e controles, os UEAA apresentam maior AGPm e maior perfil de citocinas inflamatórias sistêmicas, sugerindo que os EAA podem induzir aterosclerose por inflamação coronária e sistêmica.

Abstract Background Anabolic androgenic steroid (AAS) abuse has been associated with coronary artery disease (CAD). Pericoronary fat attenuation (pFA) is a marker of coronary inflammation, which is key in the atherosclerotic process. Objective To evaluate pFA and inflammatory profile in AAS users. Methods Twenty strength-trained AAS users (AASU), 20 AAS nonusers (AASNU), and 10 sedentary controls (SC) were evaluated. Coronary inflammation was evaluated by mean pericoronary fat attenuation (mPFA) in the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex (LCx). Interleukin (IL)-1 (IL-1), IL-6, IL-10, and TNF-alpha were evaluated by optical density (OD) in a spectrophotometer with a 450 nm filter. P<0.05 indicated statistical significance. Results AASU had higher mPFA in the RCA (-65.87 [70.51-60.70] vs. -78.07 [83.66-72.87] vs.-78.46 [85.41-71.99] Hounsfield Units (HU), respectively, p<0.001) and mPFA in the LAD (-71.47 [76.40-66.61] vs. -79.32 [84.37-74.59] vs. -82.52 [88.44-75.81] HU, respectively, p=0.006) compared with AASNU and SC. mPFA in the LCx was not different between AASU, AASNU, and SC (-72.41 [77.17-70.37] vs. -80.13 [86.22-72.23] vs. -78.29 [80.63-72.29] HU, respectively, p=0.163). AASU compared with AASNU and SC, had higher IL-1, (0.975 [0.847-1.250] vs. 0.437 [0.311-0.565] vs. 0.530 [0.402-0.780] OD, respectively, p=0.002), IL-6 (1.195 [0.947-1.405] vs. 0.427 [0.377-0.577] vs. 0.605 [0.332-0.950] OD, p=0.005) and IL-10 (1.145 [0.920-1.292] vs. 0.477 [0.382-0.591] vs. 0.340 [0.316-0.560] OD, p<0.001). TNF-α was not different between the AASU, AASNU, and SC groups (0.520 [0.250-0.610] vs. 0.377 [0.261-0.548] vs. 0.350 [0.182-430]), respectively. Conclusion Compared with ASSNU and controls, AASU have higher mPFA and higher systemic inflammatory cytokines profile suggesting that AAS may induce coronary atherosclerosis through coronary and systemic inflammation.

Measles, rubella, mumps and Toxoplasma gondii antibodies in saliva of vaccinated students of schools and universities in São Paulo City, Brazil

ABSTRACT Introduction: Vaccines are well-established public health interventions with major impacton the prevalence of infectious diseases, but outbreaks are occurring frequently due to pri-mary and secondary failures, despite high coverage. Surveillance of efficacy and duration ofinduced immunity is a difficult task as it requires invasive blood sampling in children andteenagers. Saliva can be an acceptable alternative source of IgG to assess vaccine efficacyand toxoplasmosis incidence. We investigated IgG response for measles, mumps, rubella,and T. gondii in saliva samples of vaccinated young people. Methods: Saliva was collected from 249 public schools students from São Paulo, Brazil, aged7 to 13 years old, during an interactive exhibition on hygiene. We used S. aureus proteinA solid phase capture assay for IgG reactive to biotinylated purified proteins. Paired salivaand serum (47) were tested from young adults with serum evidence of T. gondii infectionand from negative children less than 12 month old for standardization. Reproducibility wasgreater than 98% and sensitivity and specificity of the saliva assays were greater than 95%,as well as the concordance of paired saliva and serum samples. Results: Saliva from high school students showed a prevalence of 8.5% (95% CI: 5.0-11.9%)for anti T. gondii IgG; 96.8% (94.6-99%) of anti-measles IgG; 59.1% (53-65%) of anti-rubella IgG,and 57.5% (51.3-63.6%) of anti-mumps IgG. Discussion: The prevalence of antibodies against mumps and rubella after 6-8 years of vaccination was lower than against measles among students. The findings of this study demonstrate the feasibility of saliva sampling for follow-up of vaccine immune status in teenagers. This useful approach allows for IgG detection for vaccine control or epidemio- logical studies.

Measles, rubella, mumps and Toxoplasma gondii antibodies in saliva of vaccinated students of schools and universities in São Paulo City, Brazil.

INTRODUCTION: Vaccines are well-established public health interventions with major impact on the prevalence of infectious diseases, but outbreaks are occurring frequently due to primary and secondary failures, despite high coverage. Surveillance of efficacy and duration of induced immunity is a difficult task as it requires invasive blood sampling in children and teenagers. Saliva can be an acceptable alternative source of IgG to assess vaccine efficacy and toxoplasmosis incidence. We investigated IgG response for measles, mumps, rubella, and T. gondii in saliva samples of vaccinated young people. METHODS: Saliva was collected from 249 public schools students from São Paulo, Brazil, aged 7 to 13 years old, during an interactive exhibition on hygiene. We used S. aureus protein A solid phase capture assay for IgG reactive to biotinylated purified proteins. Paired saliva and serum (47) were tested from young adults with serum evidence of T. gondii infection and from negative children less than 12 month old for standardization. Reproducibility was greater than 98% and sensitivity and specificity of the saliva assays were greater than 95%, as well as the concordance of paired saliva and serum samples. RESULTS: Saliva from high school students showed a prevalence of 8.5% (95% CI: 5.0-11.9%) for anti T. gondii IgG; 96.8% (94.6-99%) of anti-measles IgG; 59.1% (53-65%) of anti-rubella IgG, and 57.5% (51.3-63.6%) of anti-mumps IgG. DISCUSSION: The prevalence of antibodies against mumps and rubella after 6-8 years of vaccination was lower than against measles among students. The findings of this study demonstrate the feasibility of saliva sampling for follow-up of vaccine immune status in teenagers. This useful approach allows for IgG detection for vaccine control or epidemiological studies.

Saliva collection and detection of anti- T. gondii antibodies of low-income school-age children as a learning strategy on hygiene, prevention and transmission of toxoplasmosis.

School-age children are a social group in which blood collection for laboratory testing can be perceived as an invasive procedure, with low acceptance and tolerance of stakeholders. This problem could be circumvented by replacing serum samples with saliva. For this purpose, and to make the collection of saliva samples playful and instructive for children, educational activities on hygiene and toxoplasmosis transmission and prevention were performed using toys and audiovisual tools. The target audience consisted of 7-10 year-old children from low-income families who attended public schools in the city of São Paulo. Saliva samples were used in a previously described in-house Enzyme-Linked Immunosorbent Assays (ELISA) to detect anti- Toxoplasma gondii IgG antibodies and establish the immunological status of each of the participants. One year later, children's memory and fixation of concepts regarding hygiene habits, as well as transmission and prevention of toxoplasmosis were tested in the same schools, by means of a questionnaire application, using students who did not participate in the first intervention as controls. The prevalence of positive anti- T. gondii IgG among students was 50% (82/164). One year later, 45 children had more knowledge on toxoplasmosis (28/45 vs 29/147) and they drew the cat's involvement in the transmission of toxoplasmosis more often than controls (28/45 vs 29/147). Sorted according to the presence of specific IgG in saliva, recovered positive students presented worse memory of the above cited knowledge as did saliva-negative IgG students, but both groups had isolated higher frequency of fixed knowledge than non-intervened students. Our data show that there is a high prevalence of T. gondii infection in school-children from low-income areas; saliva is an alternative to blood for anti- T. gondii IgG detection; and a one-day educational intervention in school-children was effective in promoting knowledge fixation on hygiene and toxoplasmosis transmission and prevention after one year.

Padronização da metodologia dot-ELISA para detecção de anticorpos IgG anti-Toxoplasma gondii em saliva / Standardization of dot-ELISA methodology for detection of IgG antibodies anti-Toxoplasma gondii in saliva

O diagnóstico da infecção pelo T. gondii é usualmente feito pelas técnicas sorológicas, mas a amostra (soro ou plasma) pode ser restrita em determinados grupos protegidos, em que a coleta de sangue é considerada agressiva e invasiva. Os anticorpos são encontrados em outros materiais biológicos, de coleta não invasiva, como a saliva. Os métodos de detecção de anticorpos no mercado estão padronizados para utilizar amostras de soro, e há metodologias alternativas de maior sensibilidade utilizando-se saliva, mas estas requerem equipamentos de difícil uso no campo. Dot-ELISA tem alta sensibilidade e leitura visual sem equipamentos, que facilita a execução de ensaio em campo utilizando-se técnica de triagem rápida e eficiente. Neste contexto, foi padronizado o dot-ELISA de alta sensibilidade para detecção de anticorpos anti-T. gondii em saliva e soro, utilizando-se amostras de 20 voluntários adultos. A sensibilidade e a especificidade do dot-ELISA padronizado foram semelhantes em soro e saliva, com exata distinção de amostras positivas e negativas, mesmo na ocorrência de baixas concentrações de anticorpos como na saliva. A saliva mostra ser material biológico adequado para detecção de anticorpos anti-T. gondii em estudos epidemiológicos da toxoplasmose em crianças ou outros grupos protegidos, em que a coleta de sangue é restrita...

A contribuição de uma liga acadêmica no ensino de graduação em enfermagem / La contribución de una liga académica en la ensenanza de gradución en enfermería / The contribution of an academic league in undergraduate teaching in nursing

Estudo quantitativo, descritivo e transversal, que objetivou identificar e avaliar a contribuição de uma liga acadêmica no ensino de graduação em enfermagem. Os dados foram coletados de maio a agosto de 2010, por meio de um questionário semiestruturado aplicado aos alunos de graduação nas dependências de uma instituição de ensino superior e enviado, via correio eletrônico, aos egressos, totalizando 22 entrevistados vinculados a uma liga de prevenção e combate ao câncer. As respostas foram estruturadas em um banco de dados na planilha Excel (Windows 2007) e, após, realizada análise por meio do software Epi Info, utilizando estatística descritiva. Respeitados os preceitos éticos. Todos os entrevistados afirmaram que a liga contribuiu para o aprendizado acadêmico. A Liga mostrou-se como uma importante estratégia de ensino, contribuindo para formação profissional, para a reflexão crítica sobre oncologia e promoção da assistência humanizada.

Estudio cuantitativo, descriptivo y transversal, cuyo objetivo fue identificar y evaluar la contribución de una liga de estudiantes de enfermería. Llevado a cabo entre mayo y agosto de 2010, a través de un cuestionario semiestructurado aplicado a estudiantes de graduación en las instalaciones de una institución de educación superior y enviado por correo electrónico, a los graduados, con total de 22 encuestados vinculados a una aleación la prevención y la lucha contra el cáncer. Las respuestas han sido estructuradas en una base de datos en Excel (Windows 2007), y después, el análisis realizado por medio del programa Epi Info, utilizando estadística descriptiva. Cumplido con las normas éticas. Todos los encuestados afirmaron que la Liga ha contribuido para el aprendizaje académico. La Liga demostró ser una enseñanza importante, que contribuye a la formación profesional, para reflexión crítica sobre oncología y promoción de la asistencia humanitaria.

This quantitative, descriptive and cross study, which aimed to identify and assess the contribution of the Students' League in the education undergraduate nursing. Data were collected from May to August 2010, using a semi-structured questionnaire, applied to graduate students on the premises of an institution of higher education and sent via electronic mail, to the graduates, a total of 22 respondents linked to a league preventing and combating cancer. The answers were structured in a database in Excel (Windows 2007), and after, the analysis performed by means of Epi Info software, using descriptive statistics. Respected the ethical rules. All respondents said that the league has contributed to academic learning. The League proved to be an important educational strategy, contributing to training to critical reflection on oncology and promoting humane care.

Prevalência de depressão e fadiga em um grupo de mulheres com câncer de mama / Prevalence of depression and fatigue in a group of women with breast cancer / Prevalencia de depresión y fatiga en un grupo de mujeres con cáncer de mama

Estudo transversal cujo objetivo foi identificar e avaliar a ocorrência de sintomas depressivos e de fadiga entre mulheres com até um ano de tratamento com radioterapia e/ou quimioterapia para o câncer de mama. Utilizou-se um instrumento com dados sociodemográficos, clínicos e terapêuticos. Para a avaliação da depressão foi aplicado Inventário de Depressão de Beck (BDI) e para a fadiga o Fatigue Questionnarie. Incluímos 31 mulheres atendidas em um núcleo de reabilitação de mastectomizadas. Os resultados mostram que 87,1% das mulheres apresentaram cansaço nas pernas, como sintoma de mal-estar relacionado à fadiga consequente ao tratamento. Em relação aos sintomas depressivos, 41,9% delas manifestaram sintomas entre leve e moderado. Os resultados apontam para a necessidade de abordagem e de condutas para o manejo dos sintomas depressivos e fadiga, além de auxiliar os profissionais da saúde a identificar as necessidades dos clientes e a desenvolver estratégias adequadas para o cuidado individualizado...

The objective of this cross-sectional study was to identify and evaluate the occurrence of symptoms of depression and fatigue in women undergoing radiotherapy and/or chemotherapy for breast cancer for one year or less. An instrument was used to collect the sociodemographic, clinical and therapeutic data. Depression was assessed using Beck's Depression Inventory (BDI), and the Fatigue Questionnaire was used to evaluate levels of fatigue. The participants were 31 women who were attending a rehabilitation center for mastectomy patients. Results show that 87.1% of the women report experiencing weakness of their legs as a symptom of fatigue-related malaise related to the treatment. Regarding depression symptoms, 41.9% reported experiencing mild to moderate symptoms. Results point to the need to develop approaches to manage symptoms of depression and fatigue, in addition to helping health professionals to identify their clients' needs and develop suitable strategies for individualized care...

Estudio transversal que objetivó identificar y evaluar la ocurrencia de síntomas depresivos y fatiga entre mujeres con hasta un año de tratamiento con radioterapia y/o quimioterapia para cáncer de mama. Se utilizó instrumento con datos sociodemográficos, clínicos y terapéuticos. Se aplicó Inventario de Depresión de Beck (BDI) para evaluación de depresión, y Fatigue Questionnaire para evaluación de fatiga. Incluimos 31 mujeres atendidas en núcleo de rehabilitación de mastectomizadas. Los resultados demuestran que 87,1% de las mujeres presentan cansancio en las piernas, como síntoma de malestar relacionado a la fatiga consecuente del tratamiento. Respecto a los síntomas depresivos, 41,9% de ellas manifestaron sintomatología de leve a moderada. Los resultados demuestran la necesidad de abordaje y conductas para el manejo de síntomas depresivos y fatiga, además de ayudar a los profesionales de salud a identificar las necesidades de las pacientes y desarrollar estrategias adecuadas para el cuidado personalizado...

Comparação da cicatrização pós-mastectomia entre mulheres portadoras e não-portadoras de diabetes mellitus / Comparison of post mastectomy cicatrization among women with or without diabetes mellitus / Comparación de la cicatrización post — mastectomía, entres mujeres portadoras y no portadoras de diabetes mellitus

Estudo transversal, quantitativo, cujo objetivo foi comparar a eficiência do processo de cicatrização pós-cirúrgica entre mastectomizadas, diabéticas e não-diabéticas. Realizado entre março e junho de 2009, em um núcleo de reabilitação de mastectomizadas de uma cidade do interior paulista. Responderam a um formulário com 13 perguntas (questões pessoais, sociodemográficas e relativas à cirurgia), 22 mulheres (11 diabéticas e 11 não-diabéticas). Os dados foram analisados por meio da estatística descritiva. Pôde-se observar que a ocorrência de deiscência da ferida operatória foi a mesma (72,8%) para os dois grupos, porém a presença de exsudato, odor e sinais flogísticos foi maior entre as mulheres diabéticas. Os maiores problemas na cicatrização ocorreram entre as diabéticas. Os resultados poderão auxiliar paciente e equipe de saúde no aprimoramento de estratégias de controle do diabetes e melhora na cicatrização pós-operatória.

Estudio de corte transversal, cuantitativo, cuyo objetivo fue comparar la eficiencia del proceso de cicatrización post- quirúrgica, entremujeres con mastectomías, diabéticas y no diabéticas. Llevado a cabo entre marzo y junio de 2009 en un centro de rehabilitación demujeres sometidas a una mastectomía en una ciudad de São Paulo. Respondieron a un cuestionario con 13 preguntas (cuestionespersonales, socio-demográficas y relacionadas con la cirugía), 22 mujeres (11 diabéticas y 11 no diabéticas). Los datos fueron analizadosa través de estadística descriptiva. Se observó que la ocurrencia de dehiscencia de la herida operatoria fue la misma (72,8%) para los dosgrupos, pero la presencia de exudado, de olor y señales de inflamación fue mayor entre las mujeres diabéticas. Los mayores problemas enla cicatrización ocurrieron entre las diabéticas. Los resultados podrán ayudar al paciente y al equipo de profesionales de la salud en lamejora de las estrategias de control de la diabetes y mejora de la cicatrización post-quirúrgica.

This a Cross-sectional quantitative study which aimed to compare the efficiency of the cicatrization process of post-surgical mastectomy,among women who have diabetes mellitus or not. It was accomplished between March and June 2009 in a nucleus of rehabilitation ofmastectomized women in a town in the countryside of São Paulo. A form was filled out by 22 women (11 diabetic and 11 non-diabetic).It consisted of (personal, demographic issues, and others related to the surgery). The data were analyzed using descriptive statistics.We could observe that the occurrence of dehiscence of the operatory wound was the same (72,8%) for both groups, but the presence ofexudates, odor and inflammation signs, was higher among diabetic women. The biggest cicatrization problems occurred among diabeticcarriers. The results may help patients and health professionals improve strategies for diabetes management and healing after surgery.