Use and Applicability of the Gail Model to Calculate Breast Cancer Risk: A Scoping Review.

OBJECTIVE: To perform a scoping review of the applicability of the Gail model in different countries for different ethnicities. METHODS: The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and search strategies based on the PICOS approach. The reviewed articles were included if they were published between 2013 and 2018 in English, Portuguese, or Spanish; were original articles available in full online; and described the use of the Gail model. The PubMed, Embase, and Web of Science data bases were searched. RESULTS: A total of 38 articles eligible for analysis were identified, of which 16 used the Gail model to assess breast cancer risk in women, eight analyzed the applicability of this tool in their population, seven compared the tool and/or modified it according to the specific risk factors of their population, and seven cited the model in determining eligibility for chemoprevention. CONCLUSION: The Gail model has different applicabilities Greater effectiveness and breast cancer risk are found in developed countries.

Sexualidade feminina após cirurgia bariátrica segundo a fenomenologia de Merleau-Ponty: revisão integrativa / Female sexuality after bariatric surgery according to the Merleau-Ponty phenomenology: integrative review / Sexualidad femenina después de la cirugía bariátrica según la fenomenología de Merleau-Ponty: revisión integrativa

Objetivo: Analisar as alterações na sexualidade das mulheres submetidas à cirurgia bariátrica, por meio de revisão integrativa da literatura. Método: A busca ocorreu nas bases Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Enfermagem, Scientific Electronic Library Online e Portal de Periódicos Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Resultados: Foram identificados 158 publicações, sendo incluídos estudos originais, quantitativos e qualitativos, publicados em inglês e português, com as palavras-chave sexualidade feminina e cirurgia bariátrica, restando 7 artigos, os quais foram analisados segundo a fenomenologia de Merleau-Ponty. Foram identificadas 4 categorias temáticas: Alterações positivas, negativas, questões médicas e fatores psicossociais. Conclusão: A essência do fenômeno se mostrou multifatorial de modo que a representação do corpo físico em alguns casos gerou melhora psicossocial, conjugal, cultural, e na sexualidade, porém não na sua plenitude de prazer e satisfação e em outros repercutiu em alterações negativas

Objective: The study's main goal has been to analyze changes in the sexuality of women who underwent bariatric surgery. In order to do so, an integrative literature review was undertaken. Methods: The search took place on the following databases: the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) [Latin American and Caribbean Literature on Health Sciences], the Base de Dados de Enfermagem (BDENF) (Nursing Database) and the Scientific Electronic Library Online (SciELO); moreover, the Periodicals Portal from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) [Coordination for the Improvement of Higher Education Personnel]. Results: A total of 158 publications were identified, including original, quantitative and qualitative studies, published in English and Portuguese. By using the keywords female sexuality and bariatric surgery, 7 articles remained, which were analyzed according to the MerleauPonty's phenomenology of perception. Four thematic categories were identified, as follows: positive, negative, medical, and psychosocial factors. Conclusion: The essence of the phenomenon was considered multifactorial. In some cases, the physical body's representation led to psychosocial, marital, cultural, and sexual improvement, yet, not in its fullness of pleasure and satisfaction. On the other hand, others have experienced negative repercussions

Objetivo: Analizar los cambios en la sexualidad de las mujeres sometidas a cirugía bariátrica, a través de una revisión integradora de la literatura. Método: La búsqueda se realizó sobre la base del Sistema de Análisis y Recuperación de Literatura Médica en línea, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Enfermería, Biblioteca Científica Electrónica en línea y Portal de Periódicas Coordinación de Mejora de Personal de Nivel Superior. Resultados: Se identificaron un total de 158 publicaciones, incluyendo estudios originales, cuantitativos y cualitativos, publicados en inglés y portugués, con las palabras clave sexualidad femenina y cirugía bariátrica, restantes 7 artículos, que fueron analizados según la fenomenología de Merleau-Ponty. Se identificaron cuatro categorías temáticas: factores positivos, negativos, médicos y psicosociales. Conclusión: La esencia del fenómeno fue multifactorial por lo que la representación del cuerpo físico en algunos casos generó una mejora psicosocial, marital, cultural y sexual, pero no en su plenitud de placer y satisfacción, y en otros tuvo repercusiones negativas

The Obesity and the Risk of Breast Cancer among Pre and Postmenopausal Women

Background: Breast cancer is the most common cancer among women worldwide and the obesity is one of the factors related to the risk of breast cancer mainly in postmenopausal women. This study investigated the association between obesity in pre- and postmenopausal women with the development of breast cancer and the expression of estrogen, progesterone, HeR-2 and triple-negative (TN) receptors. Methods: A case-control study was conducted on 100 patients with recently diagnosed breast cancer and 400 age-matched controls. The women were divided into pre- and post-menopausal groups. Results: The multivariate analysis showed that postmenopausal women with a BMI ≥ 30 kg/m2 at pre-diagnosis and at the most recent measurement were 1.50 (95% CI 1.06-2.13) and 1.56 (95% CI 1.11-2.21) times more likely to develop breast cancer, respectively. These women had a prevalence of obesity of 27.7% when considering pre-diagnosis BMI and 29.4% when analyzing the indicator of recent BMI. When only the cases regarding the presence of obesity with clinicopathological variables were analyzed, a total of 95.2% of the postmenopausal women with pre-diagnostic obesity according to BMI presented the positive estrogen receptor (ER) subtype. Conclusions: In Brazilian women, there is an association between obesity and the risk of breast cancer postmenopause; moreover, there is an association between the occurrence of the positive ER subtype in postmenopausal women and pre-diagnostic obesity according to BMI.

Diagnóstico de muerte encefálica en víctimas de accidentes: análisis del proceso / Diagnóstico de morte encefálica em vítimas de acidentes: análise do proceso / Brain death diagnosis in victims of traffic accidents: process analysis

Objetivo: Las víctimas de las causas externas de trauma, causadas ya sea por accidentes de tránsito o por la violencia en general, son en su mayoría jóvenes que evolucionan a muerte encefálica y posibles donantes. Teniendo en cuenta que el tiempo para determinar la muerte encefálica puede interferir en la calidad de los órganos ofrecidos, el propósito de este estudio fue analizar el período del proceso de diagnóstico de muerte encefálica. Material y métodos: Es un estudio descriptivo retrospectivo sobre el proceso de diagnóstico de muerte encefálica y su duración en pacientes víctimas mortales por causas externas de traumatismo en una ciudad del noroeste de Paraná, Brasil, desde enero a diciembre de 2012. Resultados: El promedio de tiempo para el período entre la confirmación del coma y el protocolo inicial para la determinación de la muerte encefálica en los cuatro hospitales fue de 18.90 ± 13.62 horas; el promedio de cierre del protocolo con Examen Complementario para los cuatro hospitales estudiados fue de 12 ± 8 horas, y el cierre con prueba clínica indicó 10 ± 6 horas. Conclusión: Los datos presentados describen una falla en todo el proceso de muerte encefálica, desde la detección de coma hasta el cierre del protocolo de diagnóstico de muerte encefálica, lo que aumenta considerablemente el tiempo de diagnóstico

As vítimas de causas externas por traumas, seja por acidentes de trânsito ou violência em geral, são em sua maioria jovens que evoluem para morte encefálica tornando-se potenciais doadores. Considerando que o tempo de determinação de morte encefálica pode interferir na qualidade dos órgãos ofertados, o objetivo deste estudo foi analisar o tempo do processo de determinação de morte encefálica. Trata-se de um estudo retrospectivo e descritivo sobre o processo de determinação de morte encefálica e sua duração, em pacientes vítimas fatais por causas externas ocasionadas por traumas, em um município do Noroeste do Paraná Brasil, no período de janeiro a dezembro de 2012. A média de tempo entre período compreendido entre a constatação do coma e início do protocolo de determinação de morte encefálica, nos quatro hospitais analisados foi de 18,90±13,62 horas e a média de encerramento do protocolo com Exame Complementar dos quatro hospitais estudados foi de 12±8 horas e do encerramento com prova clínica foi de 10±6 horas. Os dados apresentados descrevem uma falha em todo o processo de morte encefálica, desde a detecção do coma até a finalização do protocolo de determinação de morte encefálica, aumentando consideravelmente o período de tempo de seu diagnóstico

Objective: Victims of external causes of trauma, caused either by traffic accidents or by violence in general, are mostly youngsters who evolve to brain death and potential donors. Considering that the time to determine brain death may interfere on the quality of the offered organs, the purpose of this study was to analyze the period of brain death diagnosis process. Material and Methods: It is a retrospective, descriptive study on brain death diagnosis process and its duration in patients who are fatal victims due to external causes of trauma in a city in the Northwest of Paraná, Brazil, ranging from January to December 2012. Results: The average of time for the period between the coma confirmation and the initial protocol for brain death determination in the four hospitals consisted of 18.90±13.62 hours; the average of protocol closure with Complementary Examination for the four studied hospitals consisted of 12±8 hours, and closure with clinical proof indicated 10±6 hours. Conclusion: The data presented describe a failure in the entire brain death process, since coma detection until brain death diagnosis protocol closure, considerably increasing diagnosis time

Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group.

High risk pregnancies and factors associated with neonatal death.

OBJECTIVE: To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD: This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS: Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION: Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. OBJETIVO: Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. MÉTODO: Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. CONCLUSÃO: A identificação de fatores de risco pode auxiliar no planejamento de ações para consolidação da rede perinatal. Programas específicos devem ser incentivados em outros países, na busca de resultados perinatais expressivos, como a redução da mortalidade neonatal.

Prevalence of metabolic syndrome in pre- and postmenopausal women.

OBJECTIVE: The objective of this study was to determine the prevalence of metabolic syndrome (MS) and its components among pre- and postmenopausal women, as well as the association between menopausal status and MS. MATERIALS AND METHODS: A retrospective study was conducted at a reference cardiology outpatient clinic in a city located in Northwestern Paraná State, Brazil. A total of 958 medical records of symptomatic climacteric women evaluated between 2010 and 2014 were analyzed. The study consisted of two groups: pre- and post-menopausal women. MS was characterized according to the criteria of the National Cholesterol Education Program's Adult Treatment Panel III - NCEP-ATP III-2005. RESULTS: MS was observed in 18.5% of the total study population; 9.4% of the premenopausal women and 22.2% of the postmenopausal women displayed MS, corresponding to a relative risk of 2.75. In addition, the frequency of MS increased with age. Regarding the components of MS, postmenopausal women were more likely to have high density lipoprotein (HDL-C) levels < 50 mg/dL; systolic blood pressure (SBP) values ≥ 130 mmHg or diastolic blood pressure (DBP) values ≥ 85 mmHg; and fasting glucose levels ≥ 100 mg/dL. CONCLUSION: MS was more prevalent among postmenopausal women than among premenopausal women.

High risk pregnancies and factors associated with neonatal death / Gestación de alto riesgo y factores asociados con la defunción neonatal / Gestação de alto risco e fatores associados ao óbito neonatal

Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality.

Resumen OBJETIVO Identificar los factores asociados con la mortalidad neonatal intrahospitalaria con base en las características individuales de gestantes de riesgo, del parto y del recién nacido. MÉTODO Estudio epidemiológico del tipo transversal, realizado con niños nacidos vivos de partos hospitalarios de mujeres seguidas en el ambulatorio de alto riesgo de un hospital filantrópico de Maringá, Paraná, Brasil, en el período de septiembre de 2012 a septiembre de 2013. RESULTADOS Hicieron parte de la investigación 688 mujeres. El coeficiente de mortalidad neonatal fue de 7,7 defunciones/1.000 nacidos vivos, siendo su mayoría en el período neonatal precoz. Trabajo de parto prematuro, malformación fetal y gestación múltiple fueron los sucesos asociados con la defunción neonatal. Recién nacidos prematuros, con muy bajo peso al nacer e Índice de Apgar menor que siete el quinto minuto de vida presentaron riesgo elevado de muerte. CONCLUSIÓN La identificación de factores de riesgo puede auxiliar la planificación de acciones para consolidación de la red perinatal. Se deben incentivar programas específicos en otros países, en la búsqueda por resultados perinatales considerables, como la reducción de la mortalidad neonatal.

RESUMO OBJETIVO Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. MÉTODO Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013. RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. CONCLUSÃO A identificação de fatores de risco pode auxiliar no planejamento de ações para consolidação da rede perinatal. Programas específicos devem ser incentivados em outros países, na busca de resultados perinatais expressivos, como a redução da mortalidade neonatal.

Mammographic Screening of Women Attending a Reference Service Center in Southern Brazil.

BACKGROUND: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. MATERIALS AND METHODS: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. RESULTS: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. CONCLUSIONS: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

Treatment and Follow-up of Human Papillomavirus Infected Women in a Municipality in Southern Brazil.

BACKGROUND: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. MATERIALS AND METHODS: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. RESULTS: The mean age of the studied women was 27.8±7.75 years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was 13.0±0.50 years old, and the mean age at first intercourse was 17.5±1.78 years, with only 8.0% (2) initiating sexual activity at an age ≤15 years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. CONCLUSIONS: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

Pregnancy after Bariatric Surgery: Obstetric and Perinatal Outcomes and the Growth and Development of Children.

BACKGROUND: Several outcomes of pregnancy after bariatric surgery are currently being studied. METHODS: This cross-sectional, retrospective study evaluated the obstetric and perinatal outcomes of pregnancies in 19 women who underwent bariatric surgery, as well as the growth and development of their children, in the Southern Brazil. RESULTS: Among these women, 11 children were born prior to surgery and 32 were born post-surgery. The mean time between the surgery and the first pregnancy was 42.96 months. Preterm newborns were more common among the pre-surgery childbirths. Regarding growth, normal weights were observed in 27.3 % of the children in the pre-surgery births and obesity was observed in 54.5 %. In contrast, normal weights were observed in 59.4 % of the children born during the postoperative period and obesity was observed in 31.2 %. The average excess weight that the women lost prior to pregnancy was 64.88. Speech delays were found in three male children evaluated using the Denver Developmental Screening Test II. A statistical association was found between the interval from the surgery to the pregnancy and the outcome of the questionable Denver II test results (p = 0.011). CONCLUSIONS: Except for the large index of low birth weight, it can be concluded that pregnancy after bariatric surgery is safe. The growth rate was found to be adequate in the children born after the surgery, with reduced obesity. Although changes in speech development were detected, no factors were supported an association with pregnancy after bariatric surgery.

Enfrentamento de puérperas HIV positivas relacionado ao ato de não amamentar / Confronting HIV-positive mothers about the act of not breastfeeding / Enfrentamiento de puérperas HIV positivas al hecho de no amamantar

O objetivo do estudo foi conhecer os sentimentos e as dificuldades de mulheres portadoras do vírus da imunodeficiência adquirida (HIV) frente à não amamentação e à assistência oferecida. Foram entrevistadas 36 mulheres/mães portadoras do HIV com acompanhamento no ambulatório de DST/aids. Estudo qualitativo que utilizou o método do Discurso do Sujeito Coletivo, representado por meio de cinco discursos. Os resultados mais relevantes apontam que as participantes da pesquisa sofrem com a impossibilidade de não amamentar seus filhos e com a falta de um cuidado individualizado, especialmente, relativos aos problemas nas mamas. Crenças foram evidenciadas nos discursos que desmistificam o simbolismo do aleitamento, o que fortalece as puérperas para aceitar o fato de não poderem amamentar. Conclui-se que o cuidado a esse grupo específico deve privilegiar uma assistência individualizada que auxilie, especialmente, nos conflitos emocionais no processo da não amamentação, assim como nos problemas mamários.

The objective of this study was to learn the feelings and difficulties of women with the human immunodeficiency virus (HIV) in face of not breastfeeding and the care offered to them. Thirty-six women/mothers with HIV and under follow-up at an STD/Aids outpatient clinic were interviewed. A qualitative study was conducted, using the Collective Subject Discourse method, which was represented by means of five discourses. The most relevant results show that the study participants suffer as a result of not being able to breastfeed their children and the lack of individualized care, especially regarding breast i ssues. The discourses evidenced beliefs that demystify the symbolism of breastfeeding, which strengthens these women to accept the fact that they cannot breastfeed. In conclusion, the care for this specific group must be individualized so as to assist them, especially, with their emotional conflicts in the non-breastfeeding process, as well as with their breast problems.

Se objetivó conocer los sentimientos y las dificultades de mujeres portadoras del virus de inmunodeficiencia adquirida (HIV) ante el no amamantamiento y la atención ofrecida. Fueron entrevistadas 36 mujeres/madres portadoras de HIV con seguimiento en ambulatorio de DST/SIDA. Estudio cualitativo, utilizando el Discurso del Sujeto Colectivo, representado mediante cinco discursos. Los resultados más relevantes expresan que las participantes de la investigación sufren ante la imposibilidad de amamantar a sus hijos y con la falta de cuidados personalizados, especialmente en lo relativo a problemas en las mamas. Las creencias fueron evidenciadas en los discursos, que desmitifican el simbolismo de la lactancia, lo cual ayuda a las puérperas a aceptar el hecho de no poder amamantar. Se concluye en que el cuidado del grupo específico debe privilegiar una atención personalizada, que colabore, particularmente, en los conflictos emocionales relativos al proceso de no amamantamiento, así como en los problemas mamarios.

Variables that affect the satisfaction of Brazilian women with external breast prostheses after mastectomy.

BACKGROUND: : In 2012, the breast cancer estimate worldwide stood at 1.67 million new cases, these accounting for 25% of all types of cancer diagnosed in women. For 2014, 57,120 new cases are expected, with a risk estimated at 56.1 cases for every 100,000 women. The objective of this study was to analyze the satisfaction regarding the use of external breast prostheses by women undergoing mastectomy. MATERIALS AND METHODS: This cross-sectional study was conducted with 76 women who used an external breast prosthesis (EBP), registered in the services of the Cuiaba Center for Comprehensive Rehabilitation, Mato Grosso, Brazil, from 2009 to 2012. Data were collected from the records of women who had requested the opening of a process of external breast prosthesis concession. RESULTS: Satisfaction with the EBP was identified in 56.6% of the women. Those satisfied with the EBP reported that its weight was not annoying (p<0.01). Although the women felt body sensations of stitches, pains, pulling, dormancy and phantom limb, they are satisfied with the EBP. The variable related to the displacement of the breast prosthesis during activity of everyday life has demonstrated that even though the women have reported the possibility of displacements, they are satisfied with the EBP. The satisfaction with the use of external breast prosthesis did not affect the sexuality of the women with mastectomy. CONCLUSIONS: Learning the specificities of the EBP, taking into consideration the satisfaction of its use, allows the rehabilitation team, by listening to their clientele more attentively, following up this woman throughout her life journey, supporting and guiding the best way of use, with an eye to her personal, emotional and social life, as well as to her self-esteem.

Avaliação dos exames citológicos de papanicolau em usuárias do sistema único de saúde / Evaluaciónde frootis de papanicoLaou en los usuarios del sistema único de salud / Evaluation f papp smears in users of the unified health system

Mundialmente, entre todos os tipos de câncer, na população feminina, o câncer de colo uterino é um dos mais frequentes, ocupando o segundo lugar em incidência. O objetivo do presente trabalho é estimar a prevalência de exames colpocitológicos realizados no município de Maringá, Paraná, e sua distribuição segundo a faixa etária das mulheres e os resultados dos exames. Trata-se de um estudo descritivo, retrospectivo, de coorte, constando da análise de todos os exames colpocitológicos realizados em 24 Unidades Básicas de Saúde (UBS) do município de Maringá, no período de 2006 a 2010. Foram estudados 41.197 exames, a média de idade foi de 41,66±14,18 anos, variando de 12 a 93 anos. Cerca de 75,4% das mulheres (12.579) estavam na faixa etária dos 25 aos 59 anos; 12,7% (2.129) tinham entre 12 e 24 anos e as demais, 11,9% (1.993), possuíam acima de 60 anos de idade. Foi observado que 48,4% dos exames estavam normais; 22,7% apresentavam alterações celulares benignas e 26,7%, atipias celulares. Em 498 mulheres, o laudo citopatológico foi positivo para neoplasia. Uma melhor qualidade de informação poderá permitir avaliações de cobertura, áreas de maior acometimento, de forma a possibilitar a implementação de medidas, visando a prevenção de neoplasias intraepiteliais cervicais.

Entre todos los tipos de cáncer en mujeres en todo el mundo, el cáncer de cuello uterino es el más frecuente, ocupando el segundo lugar en incidencia. El objetivo del estudio fue estimar la prevalencia de citología cervical realizado en Maringá, Paraná, Brasil. Se trata de una cohorte descriptivo, retrospectivo, que consiste en el análisis de toda la citología cervical realizado en 24 Unidades Básicas de Salud (UBS) de Maringá, de 2006 a 2010. Hubo 41.197 pruebas, la edad promedio fue de 41,66±14,18 años, de 12 a 93 años. Aproximadamente el 75,4% de las mujeres (12.579) tenían entre 25 a 59 años, 12,7% (2.129) tenían entre 12 y 24 años y el restante, 11,9% (1.993), tenían más de 60 años de edad. El 48,4% de los exámenes fueron normales, el 22,7% tenían cambios celulares benignos y 26,7%, células atípicas. En 498 mujeres, el informe citología fue positivo para malignidad. Una mejor calidad de información puede permitir evaluaciones de la cobertura, las zonas más afectadas, con el fin de permitir la aplicación de medidas destinadas a la prevención de la neoplasia intraepitelial cervical.

Among all types of cancer in women, around the world, cervical cancer is the most frequent, ranking second in incidence. The objective of the study was toestimate the prevalence of cervical cytology performed in Maringá, Paraná, Brazil. This is a descriptive, retrospective cohort, consisting of analysis of all cervical cytology performed on 24 Basic Health Units (BHU) of Maringá, from 2006 to 2010. There were 41,197 tests, the average age was 41.66±14.18 years, ranging from 12 to 93 years. Approximately 75.4% of women (12,579) were aged 25 to 59 years; 12.7% (2,129) were between 12 to and 24 years and the remaining 11.9% (1,993) were over 60 years of age. Were observed that 48.4% of the exams were normal, 22.7% had with benign cellular changes and 26.7% showed, atypical cells. In 498 women, the report cytology was positive for malignancy. A better quality of information may permit assessments of coverage, areas most affected, in order to enable the implementation of measures aimed at preventing cervical intraepithelial neoplasm.

Mulheres em idade fértil: causas de internação em unidade de terapia intensiva e resultados / Women of childbearing age: causes of hospitalization in intensive care unit and results

INTRODUÇÃO: Pacientes obstétricas representam uma fração significativa das admissões em unidades de cuidado intensivo e consistem em um desafio para a equipe. OBJETIVO: Analisar as principais causas de internação e morte materna de mulheres em idade fértil ocorridas em unidades de terapia intensiva de hospitais de um município do Noroeste do Paraná, Sul do Brasil. MÉTODOS: Estudo exploratório, descritivo, retrospectivo, realizado com mulheres em idade fértil (10 a 49 anos) internadas em três unidades de terapia intensiva existentes em um município do Noroeste do Paraná, por causas obstétricas e não obstétricas, no período de janeiro de 2005 a dezembro de 2009. RESULTADOS: Foram encontradas 775 internações de mulheres em idade fértil, com uma média de idade de 33,7±10,3 anos, com duração média de internação de 5,0±8,4 dias. A maior parte das mulheres era do município estudado (67,2%), com baixa escolaridade (nível primário, 68,2%). Entre as causas obstétricas de internação, a pré-eclâmpsia grave e a eclâmpsia se constituíram na principal causa (71,3%); a pielonefrite se destacou sob outras condições no período gestacional (53%). Não foi encontrada associação estatística entre internações por causas obstétricas em unidade de terapia intensiva e óbito. CONCLUSÃO: As causas não obstétricas representaram a maioria das internações de mulheres em idade fértil nas unidades de terapia intensiva do município, no período estudado e, entre as causas obstétricas, a pré-eclâmpsia grave e a eclâmpsia constituíram a principal causa.

INTRODUCTION: Obstetric patients represent a significant fraction of admissions to intensive care units and consist of a challenge to the team. Objective: To analyze the main causes of maternal death and hospitalization of women of childbearing age occurring in intensive care units of hospitals in a city in Northwestern Paraná, Southern Brazil. METHODS: Exploratory, descriptive and retrospective study, conducted with women of childbearing age (10-49 years) admitted in three intensive care units existing in a city of Northwest Paraná, for obstetric and non-obstetric causes, from January 2005 to December 2009. RESULTS: There were 775 admissions of women of childbearing age, with a mean age of 33.7±10.3 years; the mean duration of hospitalization was 5.0±8.4 days. Most of the women were from the municipality (67.2%), with low education level (primary level, 68.2%). Among the obstetric causes of hospitalization, pre-eclampsia and eclampsia constituted the main cause (71.3%); pyelonephritis stood out other conditions during pregnancy (53%). There was no statistical association betweenhospital admissions for obstetric causes in intensive care unit and death. CONCLUSION: Non-obstetric causes accounted for the majority of hospitalizations of women of childbearing age in the intensive care unit of this municipality during the study period; among obstetric causes, pre-eclampsia and eclampsia were the main causes.

Terapia dialítica em mulheres do estado do Paraná, município de Maringá e região metropolitana / Dialysis therapy in women from Parana State, Maringa city and metropolitan region

O objetivo deste estudo foi analisar a prevalência de diálise em mulheres no estado do Paraná, município de Maringá e região metropolitana. Estudo quantitativo, descritivo, de corte transversal. Foi estudada a prevalência de diálise em mulheres no estado do Paraná, município de Maringá e região metropolitana, no período de 1999 a 2007, através do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA/SUS), no programa do Departamento de Informática do Sistema Único de Saúde (DATASUS).Houve aumento da taxa de prevalência de diálise em mulheres no estado do Paraná, município de Maringá e região metropolitana no período de 1999 a 2007. No estado do Paraná, houve um crescimento de 1,71 mulheres em diálise por 100.000 habitantes do sexo feminino anualmente (p≤0,05), as faixas etárias 30 a 59 anos e 60 anos e mais se revelaram como fatores de risco para realizar diálise no sexofeminino. No município de Maringá e região metropolitana, houve um crescimento de 0,88 de mulheresem diálise por 100.000 habitantes do sexo feminino anualmente (p≤0,05), a faixa etária 60 anos e mais se revelou como fator de risco para realizar diálise no sexo feminino.

The aim of this study was to analyze the prevalence of dialysis in women in the state of Paraná, Maringá and metropolitan region. It is a quantitative, descriptive and transversal cut study. We studied the prevalence of dialysis in women from Parana state, Maringa city and metropolitan region in the period1999 to 2007 through the Outpatient Information System of the Unified Health System (SIA / SUS), theprogram of the Department of Informatics Unified Health System (DATASUS). Increased prevalence ofdialysis in women from Parana state, Maringá and metropolitan region in the period 1999 to 2007. In the Paraná state, an increase of 1,71 women per 100,000 dialysis females annually (p ≤ 0.05), ages 30 to 59 years and 60 years and more were revealed as factors risk to perform dialysis in females. In Maringa and the metropolitan region, an increase of 0,88 women per 100,000 dialysis females annually (p ≤ 0.05),age 60 years and more was revealed as a risk factor to perform dialysis in females.

[Climacteric symptoms and nutritional status of women in post-menopause users and non-users of hormone therapy]. / Sintomas climatéricos e estado nutricional de mulheres na pós-menopausa usuárias e não usuárias de terapia hormonal.

PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.

Population inquiry regarding mammography in postmenopausal women in southern Brazil.

This study was conducted to analyze the prevalence of non-performance of mammography, and associated factors, among postmenopausal women. This analytical, exploratory, cross-sectional study, of a domicile population inquiry type, was performed in the municipality of Maringa, Parana, Brazil. A total of 456 women were interviewed, aged 45 to 69 years, who presented with natural menopause and cessation of menstruation for at least twelve months. Statistical associations were found between the non-performance of mammography and schooling of less than seven years, paid employment, sedentary lifestyle, smoking, the non-use of hormone replacement therapy, not having consulted a doctor in the previous year, not having consulted a gynecologist, lacking a family history of breast cancer, not having performed the Papanicolaou test, not having performed clinical breast examination, and not having difficult access to health services. After logistic regression analysis, not performing mammography was associated with reports of a fair or bad health status. The study data revealed factors "responsible" for the non-performance of mammography, and the results should contributing to improvement/enhancement of healthy behaviour of Brazilian women in the post-menopausal phase.

[Heavy alcohol consumption among women]. / Consumo abusivo de álcool em mulheres.

This descriptive, exploratory study aimed to characterize women attending a Teaching Hospital in Northwest Paraná, for alcohol abuse in the years 1999 to 200, according to sociodemographic data of intoxication and associated with trauma and violence. Among 823 visits, the most frequent age range was from 20 to 49 years (58.32%). 13 (1.58%) were pregnant, 12.5% had 9-12 years of schooling. Liquor was the main beverage used and its intake was more prevalent at night. Approximately 156 (18.96%) women required hospitalization. Hospital avoidance was observed in 8.5% of cases. We conclude that woman are likely to abuse alcohol, and this study enabled a description of the areas in women's health that are impacted allowing the implementation of preventive measures to decrease occurrence and recurrence in this population.

[Factors associated with lack of Pap smear screening in a group of postmenopausal Brazilian women]. / Papanicolaou na pós-menopausa: fatores associados a sua não realização.

This study aimed to analyze risk factors for lack of Pap smear screening among menopausal women. This population-based study evaluated 456 women 45-69 years of age (mean 58.7; SD 5.7), with age at menopause 48.0 years (SD 5.0) living in the urban area of Maringá, Paraná State, Brazil. Most reported having 7 years of schooling or less, were married or living with a partner, had paid work, were sedentary, and were not on hormone replacement therapy. Coverage of Pap smear screening was 84.5%. After adjustment by multivariate analysis, the 45-69-year age bracket, paid work, no visit to the gynecologist in the previous year, and no mammogram in the two previous years were statistically associated with lack of Pap smear screening. Efforts to improve cervical cancer screening should focus on women's knowledge and reduce the factors that hinder women from performing Pap smear tests.