Screening and hospitalization of breast and cervical cancer in Brazil from 2010 to 2022: A time-series study.

In Brazil, during the pandemic caused by COVID-19, screening for breast and cervical cancers was postponed or interrupted due to the prevailing health conditions. These neoplasms, however, are responsible for high morbidity and mortality among women in Brazil and have a major impact on the quality of life of this population and public health. Thus, this study aims to evaluate the epidemiological behavior of hospitalization for cervical and breast cancer in Brazilian women, as well as the trend of screening tests of breast and cervical cancer in the years 2010 to 2022 according to the regions of Brazil. This is ecological research of time series, based on secondary data obtained from information systems of the country, about hospital admissions for breast and cervical cancer and screening methods used for these tumors. The data were analyzed in the Joinpoint Regression Program, to obtain the linear regression and temporal analysis of the variables. As a result, between 2010 and 2022, the rates of mammography varied from 36 to 71 exams, while in the pap smear, the variations were 126 and 226 cytopathological exams per 1000 women. Hospitalizations for these cancers peaked in 2019, with 48 hospitalizations for cervical cancer per 100,000 women and 147 hospitalizations for breast cancer for the same population. For both, in the pandemic years, between 2020 and 2022, there is a decrease in Brazil and in all its regions. As for the tracking of these diseases, it was observed that the performance of mammograms and preventive tests showed a similar behavior, in which there is a higher supply of these tests until 2019 and a drop during the pandemic period. This leads to the conclusion that even though Brazil has several policies for the screening of these diseases, there is still instability in the offering of these tests and that there was instability in this area during the pandemic.

Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection.

INTRODUCTION: The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. OBJECTIVE: Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. METHODS: This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. RESULTS: A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. CONCLUSION: This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.

Upper extremity motor quality evaluation in children with Cerebral Palsy / Avaliação da qualidade motora das extremidades superiores de crianças com Paralisia Cerebral

Abstract Introduction: Cerebral Palsy (CP) is a non-progressive disorder that may compromise functional abilities of the upper limbs due to motor and sensitive loss, that are still poorly evaluated and described by reliable tools. Objective: This study aimed to evaluate motor quality and skills of the upper extremity in children with CP in regions of Trairi and Seridó from Rio Grande do Norte state (Brazil). Methods: It is a cross-sectional exploratory study, with a qualitative approach, with 17 children with CP, aged between four and eight years. The following instruments were used for upper extremity evaluation: Manual Ability Classification System (MACS), Quality of Upper Extremity Skills Test (QUEST) and Gross Motor Function Classification System (GMFCS). Results: Mean and standard deviation (sd) of QUEST total score and the domains dissociated movement, grasp, weight bearing and extensive protection were, respectively, 41.06/37.08; 53.12/34.50; 15.51/62.98; 37.76/37.52; 42.48/47.26. MACS and GMFCS median scores were, respectively, 3 (three) and 5 (five); high positive correlation was observed between MACS and GMFCS (rs=0.83) and high negative correlation between GMFCS and total QUEST (rs=-0.83), as well as between MACS and QUEST (rs=-0.84); and MACS and all QUEST domains (rs=-0.73; rs=-0.82; rs=-0.76; rs=-0.79), p<0.001. Conclusion: Children with CP showed deficit in motor quality and skills of the upper limb, allowing to infer functional limitations regarding manipulation of objects and consequent dependence during life activities.

Resumo Introdução: A Paralisia Cerebral (PC) é uma desordem não progressiva que pode comprometer as habilidades funcionais dos membros superiores, frequentemente decorrentes das perdas motoras e sensitivas, que são ainda pouco avaliadas e descritas por meio de instrumentos confiáveis. Objetivo: Este estudo teve como objetivo avaliar a qualidade de habilidades motoras e da extremidade superior em crianças com paralisia cerebral em regiões de Trairi e Seridó do estado do Rio Grande do Norte (Brasil). Métodos: Estudo exploratório, com abordagem qualitativa e estrutura transversal, com 17 crianças com PC, com idades entre quatro e oito anos. Foram utilizados os seguintes instrumentos para avaliação da extremidade superior: Sistema de Classificação da Habilidade Manual (MACS), Teste de Qualidade de Habilidades da Extremidade Superior (QUEST) e Sistema de Classificação da Função Motora Grossa (GMFCS). Resultados: A média e o desvio padrão da pontuação total QUEST e domínios dissociação de movimento, preensão, descarga de peso e resposta extensiva protetora foram, respectivamente, 41,06/37,08; 53,12/34,50; 15,51/62,98; 37,76/37,52; 42.48/47.26. As pontuações medianas do MACS e GMFCS foram, respectivamente, de 3 (três) a 5 (cinco), sendo observados alta correlação positiva entre MACS e GMFCS (rs=0,83) e alta correlação negativa entre o GMFCS e QUEST totais (rs=-0,83), bem como entre MACS e QUEST (rs=-0,84); MACS e todos os domínios QUEST (rs=-0.73; rs=-0.82; rs=-0.76; rs=-0.79), p<0,001. Conclusão: As crianças com PC apresentaram déficit de qualidade motora e habilidades do membro superior, possibilitando inferir limitações funcionais quanto à manipulação de objetos e consequente dependência durante atividades de vida.