Breast cancer risk assessment in a mammography screening program and participation in the IBIS-II chemoprevention trial.

It has been shown in several studies that antihormonal compounds can offer effective prophylactic treatment to prevent breast cancer. In view of the low participation rates in chemoprevention trials, the purpose of this study was to identify the characteristics of women taking part in a population-based mammography screening program who wished to obtain information about the risk of breast cancer and then participate in the the International Breast Cancer Intervention Study II (IBIS-II) trial, a randomized double-blind controlled chemoprevention trial comparing anastrozole with placebo. A paper-based survey was conducted in a population-based mammography screening program in Germany between 2007 and 2009. All women who met the criteria for the mammography screening program were invited to complete a questionnaire. A total of 2,524 women completed the questionnaire, and 17.7% (n = 446) met the eligibility criteria for the IBIS-II trial after risk assessment. The women who wished to receive further information about chemoprevention were significantly younger (P < 0.01) and had significantly more children (P = 0.03) and significantly more relatives with breast cancer (P < 0.001). There were no significant differences between the participants with regard to body mass index or hormone replacement therapy. Normal mammographic findings at screening were the main reason (42%) for declining to participate in the IBIS-II trial or attend risk counseling. The ultimate rate of recruitment to the IBIS-II trial was very low (three women). Offering chemoprevention to women within a mammography screening unit as part of a paper-based survey resulted in low participation rates for both, the survey and the final participation in the IBIS-II trial. More individualized approaches and communication of breast cancer risk at the time of the risk assessment might be helpful to increase the participation and the understanding of chemopreventive approaches.

Controle da pressão arterial, do diabetes mellitus e da dislipidemia na população de hipertensos de um ambulatório de residência médica / Blood pressure, diabetes and dislipidemia control of pacients with hypertension at a medical residence ambulatory

A hipertensão arterial sistêmica (HAS) é uma condição muito prevalente que pode estar associada a outros fatores de risco para doenças cardiovasculares. Neste estudo avaliaram-se pacientes hipertensos de um ambulatório de residência de clínica médica, objetivando analisar primariamente a frequência do controle da HAS e, secundariamente, o controle do diabetes mellitus e da dislipidemia, quando estes estavam associados. Também se coletaram dados sobre medicações em uso. O controle da HAS foi verificado em 53,7% da população total estudada, em 50,7% dos pacientes hipertensos e dislipidêmicos e em 45% dos hipertensos e diabéticos. O controle isolado da dislipidemia foi de 55,38% e do diabetes foi de 12,5%, e apenas 26,1% e 7,5% apresentaram controle simultâneoda HAS/dislipidemia e da HAS/diabetes, respectivamente. O controle simultâneo da HAS, da dislipidemia e do diabetes mellitus não ocorreu em nenhum indivíduo estudado, visto que dez pacientes apresentavam estas três patologias concomitantemente. A média de idade foi de 61,83 ±12,89 anos, sendo a maioria mulheres (66,1%). Em média, os pacientes usavam 2,40 fármacos anti-hipertensivos diferentes para tratar a doença. Apenas 17,4% estavam em monoterapia. A classe de fármaco mais usada foi a dos diuréticos (81%). Apesar do melhor controle da HAS encontrado neste estudo quando comparado com a literatura...

The high blood pressure is a very prevalent disease that can be associated to other risk factors to cardiovascular diseases. At this study we evaluate hypertensive out patients from an internal medicine residence clinic. The first objective was to asses the frequency rations of hypertension control and, secondly, the rations of diabetes mellitus and dyslipidemia controls when they were associated. We also collected data of the medications’ use. The high blood pressure control was verified in 53,7% of the hypertension population; 50,7% in hypertensive patients with dyslipidemia and, 45% in hypertensives with diabetes. These gregated control of dyslipidemia was 55,38% and the diabetes was 12,5% and only 26,1% and 7,5% of the patients had concurrent control of hypertension/dyslipidemia and hypertension/diabetes, respectively. The simultaneous control of hypertension, diabetes and dyslipidemia didn’t happen with any individual, and 10 pacients had the three pathologys concomitantly. The media of age was 61,83± 12,89 year old, been the most part of women (66,1%). On average, the patients used 2,40 different types of antihypertensive drugs to treat the disease. Only 17,4% were at monotherapy treatment. The most used drug was the diuretics. Although there was better control of high blood pressure in this study when compared with literature...