Inflammatory and cytotoxic mediators in COVID-19 patients and in ChAdOx1 nCoV-19 (AZD1222) vaccine recipients.

Immunological and cytotoxic mediators are induced in natural infection and are essential for the effectiveness of vaccination. Vaccination is useful to prevent the spread of SARS-CoV-2 and limit the morbidity/mortality of COVID-19. ChAdOx1 nCoV-19 is one of the most widespread vaccines in the world. We compared the detection of anti-S1 SARS-CoV2 IgG and the profile of inflammatory and cytotoxic responses of patients who developed different clinical outcomes of COVID-19 with individuals previously exposed or not to the virus received the first and booster doses of ChAdOx1 nCoV-19. Plasma from 35 patients with COVID-19 and 11 vaccinated were evaluated by multiplex assay. Here, no vaccinated subjects had serious adverse effects. Those vaccinated with a booster dose had higher anti-S1 IgG than mild/moderate and recovered patients. Critically ill and deceased patients had IgG levels like those immunized. By univariate analysis, IL-2, IL-17, and perforin do not differentiate between patients and vaccinated individuals. Granzyme A increased at dose 1, while patients had their levels reduced. High levels of granulysin, sFas, and IL-6 were detected in the deaths, but after vaccination, all were declined. The multivariate analysis supports the role of IL-6 and granulysin as associated and non-confounding variables related to the worst clinical outcome of COVID-19, but not sFas. Our data confirm the ability of the ChAdOx1 vaccine to produce specific antibody levels up to booster time. Furthermore, our data suggest that the vaccine can regulate both the hyper-production and the kinetics of the production of inflammatory and cytotoxic mediators involved in the cytokine storm, such as granulysin and IL-6.

Use of prophylactic phototherapy for RhD neonatal disease in a referral service

Abstract Objective: This study aimed to describe the effect of prophylactic phototherapy in the treatment of infants with Neonatal Hemolytic Disease. Method: A retrospective cohort study was carried out with 199 RhD-positive infants, born to RhD-negative mothers, alloimmunized for RhD antigen, between January 2009 and December 2018. Results: The incidence of exchange transfusions in the study population was 9.5%, with a mean maximum bilirubin value of 11.3 mg % (± 4.3mg %). Bilirubin's maximum peak was achieved with a mean of 119.2 life hours (± 70.6h). Conclusions: The low incidence of exchange transfusion, the extended maximum bilirubin peak for later ages, and the low mean of the maximum bilirubin values may indicate a positive effect of prophylactic phototherapy in the treatment of this disease. Further studies must be carried out to confirm these findings.

Use of prophylactic phototherapy for RhD neonatal disease in a referral service.

OBJECTIVE: This study aimed to describe the effect of prophylactic phototherapy in the treatment of infants with Neonatal Hemolytic Disease. METHOD: A retrospective cohort study was carried out with 199 RhD-positive infants, born to RhD-negative mothers, alloimmunized for RhD antigen, between January 2009 and December 2018. RESULTS: The incidence of exchange transfusions in the study population was 9.5%, with a mean maximum bilirubin value of 11.3 mg % (± 4.3mg %). Bilirubin's maximum peak was achieved with a mean of 119.2 life hours (± 70.6h). CONCLUSION: The low incidence of exchange transfusion, the extended maximum bilirubin peak for later ages, and the low mean of the maximum bilirubin values may indicate a positive effect of prophylactic phototherapy in the treatment of this disease. Further studies must be carried out to confirm these findings.

Relações de gênero e trabalho das mulheres na Cadernos de Psicologia Social e do Trabalho: uma revisão bibliográfica (1998-2018) / Gender relations and women's work in the Cadernos de Psicologia Social do Trabalho: an overview of its first two decades (1998-2018)

A relação entre trabalho e gênero tem se apresentado como um frutífero campo de estudos nas ciências sociais e humanas. O crescente interesse por essa relação também está presente na Psicologia. Em especial, no campo da Psicologia Social do Trabalho as análises sobre os processos de trabalho são articuladas com dimensões fundamentais para a compreensão do funcionamento da sociedade, tais como raça, classe e gênero. Neste trabalho, por meio de uma revisão de caráter narrativo, buscamos descrever e analisar como o trabalho das mulheres e as relações de gênero têm sido investigados nos artigos publicados na revista Cadernos de Psicologia Social do Trabalho. Para isso, levantamos os artigos publicados nessa revista de 1998 a 2018, selecionando um corpus total de 72 artigos. Nossa análise foi dividida em duas etapas: na primeira, abarcamos uma análise descritiva do corpus, e na segunda, realizamos uma profunda análise qualitativa. Os resultados da análise descritiva apontaram que houve um aumento no número total de publicações que abordam questões de gênero e uma diminuição no número proporcional em relação ao total de artigos publicados. Com base na análise qualitativa, argumentamos que ainda existem desafios teóricos e metodológicos a serem superados para que a temática se consolide na psicologia social do trabalho

The relationship between work and gender has been presented as a fruitful field of study in social and human sciences. The growing interest in this relationship is also present in Psychology. In particular, in the field of Social Psychology of Work, analyses of work processes are articulated with fundamental dimensions for understanding the functioning of society, such as race, class, and gender. In this work, with a narrative review, we seek to describe and analyze how women's work and gender relations have been investigated in articles published in the journal Cadernos de Psicologia Social do Trabalho. For this, we surveyed the articles published in this journal from 1998 to 2018, selecting a total corpus of 72 articles. Our analysis was divided into two stages: in the first, we covered a descriptive analysis of the corpus and, in the second, we did an in-depth qualitative analysis. The results of the descriptive analysis indicate an increase in the total number of publications that address gender issues, and a decrease in the proportional number regarding the total number of published articles. Based on the in-depth qualitative analysis, we argue that there are still theoretical and methodological challenges to be overcome for the consolidation of this theme in social psychology of work

Um resgate de si: itinerário terapêutico de um caso de adoecimento mental relacionado ao trabalho / Rescuing yourself: therapeutic itinerary of a case of work-related mental illness

Este artigo apresenta uma reflexão sobre o processo de reabilitação de adoecimento mental relacionado ao trabalho por meio da reconstituição do Itinerário Terapêutico de uma trabalhadora, evidenciando a importância dos serviços públicos de saúde. Mesmo diante do expressivo aumento dos casos de adoecimento mental e das evidências de relação com as condições e formas de organização do trabalho, raramente as situações laborais são consideradas nas avaliações dos serviços de saúde. Mesmo com o atual contexto de desmonte da saúde pública, existem exemplos de atuações exitosas, como a que discutimos aqui. Por meio de entrevista semidirigida com uma trabalhadora e construção do Itinerário Terapêutico, buscou-se compreender seu processo de adoecimento mental, a relação com o trabalho e o percurso de reabilitação. Os resultados demonstram a importância do entendimento do trabalho como determinante de saúde, da elaboração de projetos terapêuticos singulares e da atenção integral, revelando que a articulação em rede, o estabelecimento de vínculo e a busca pelo protagonismo do usuário são essenciais na atenção à saúde mental relacionada ao trabalho.

This article presents a reflection on the process of rehabilitation of work-related mental illness through the reconstitution of a worker's Therapeutic Itinerary, highlighting the importance of public health services. Even in the face of significant increase in cases of mental illness and evidence of a relationship with the conditions and forms of work organization, work situations are rarely considered in the assessments of health services. However, despite the current context of dismantling the public health system, there are examples of successful actions, such as the one we discussed here. Through a semi-directed interview with a worker and construction of the Therapeutic Itinerary, we sought to understand her mental illness process, the relationship with work and the path of rehabilitation. The results demonstrate the importance of understanding work as determinant of health, the development of unique therapeutic projects and comprehensive care, revealing that networking, establishing a bond and seeking the protagonism of the user are essential in work-related mental health care.

Analysis of immediate use of sunscreen after microneedling.

INTRODUCTION: Microneedling promotes skin microlesions that lead to an inflammatory process, increasing cell proliferation, cell metabolism, and synthesis of collagen and elastin, therefore restoring skin integrity. OBJECTIVE: This study aims to investigate the differences between the physical and the physical-chemical sunscreen application after microneedling, assessed through histological analysis. METHOD: This was a two-phase study. The first phase investigated the physical and physical-chemical sunscreen penetration mixed with India ink through histological analysis. The sunscreens were applied after the microleakage in vivo on the skin of a volunteer who underwent abdominoplasty 24 hours after the procedure. Histological analyses were carried out using optical and electron microscopy. The second phase analysed the skin reactions with the use of physical sunscreen after different microneedling treatments. The sample consisted of 30 volunteers distributed into three groups: G1 received the "Roller" microneedling, G2 received pen micropuncture treatment, and G3 received the fractional radiofrequency treatment. RESULTS: The histological analyses of the first phase indicated that the physical-chemical protection sunscreen penetrated more deeply, and pigment was found among the collagen fibres and the dermal fibroblast cytoplasm in comparison to the physical protection sunscreen, which had the pigment confined exclusively in the superficial epidermis layer. The second phase results demonstrated that the use of the physical protection sunscreen after the different microneedling techniques showed no adverse reactions such as itching, pain or soreness, and the hyperaemia. CONCLUSION: The proposed intervention showed that the use of physical protection sunscreen after different microneedling procedures is safe.

Protocolo de fototerapia profilática para doença hemolítica perinatal no Instituto Fernandes Figueira: avaliação de 10 anos de sua utilização / Prophylactic phototherapy protocol for perinatal hemolytic disease at the Fernandes Figueira Institute: a 10-year evaluation of its use

Introdução: Na doença hemolítica perinatal há anticorpos maternos contra antígenos das hemácias fetais, provocando sua hemólise. Esses anticorpos têm passagem ativa pela placenta, desta forma gerando complicações tanto no período intrauterino quanto no pós-natal. Após o nascimento a maior complicação é a hiperbilirrubinemia, com risco de neurotoxicidade. A fototerapia é uma medida altamente eficaz no controle desta complicação, porém em casos extremos pode ser necessário a exsanguineotransfusão, um procedimento invasivo com riscos de morbidade e mortalidade. No Instituto Fernandes Figueira foi iniciado, em 2006, uso de fototerapia profilática de forma a padronizar a terapia nos recém-nascidos com doença hemolítica perinatal pelo RhD. Objetivo: Descrever os resultados da fototerapia profilática na evolução clínica dos recém-nascidos com doença hemolítica perinatal pelo anticorpo RhD, com especial atenção à incidência de exsanguineotransfusão. Métodos: Foi realizado um estudo de coorte retrospectiva. Foram selecionados recém-nascidos Rh positivo com Coombs direto positivo, filhos de mães RhD negativo, aloimunizadas para o antígeno RhD, nascidos no período de janeiro de 2009 a dezembro de 2018. Resultados: Foram incluídos 199 recém-nascidos no estudo. Na amostra, foi encontrada média de valor máximo de bilirrubina de 11,33 mg ±4,26, sendo atingido o pico máximo de bilirrubina com média de 119,23 horas de vida (±70,57); e 9,5% necessitaram de exsanguineotransfusão. O tempo de fototerapia apresentou mediana de 6 dias (IQR: 5-7) com mediana de 8 dias (IQR: 6-11) de internação. Em 32,2% dos casos houve hipotermia como complicação da fototerapia. Ocorreram 3 óbitos, em recém-nascidos pré termos, nascidos por sofrimento fetal agudo iniciado durante procedimento de transfusão intrauterina. Conclusão: Neste estudo foi encontrada uma baixa incidência de exsanguineotransfusão. É possível observar que o pico máximo de bilirrubina ocorreu em momentos mais tardios e que foram encontrados baixos valores de bilirrubina máxima. Contudo, apesar de potencial benefício, mais estudos são necessários para se obter dados mais fidedignos sobre o impacto da fototerapia profilática nos recém-nascidos no curto e médio prazo.

Introduction: In perinatal hemolytic disease there are maternal antibodies against fetal red cell antigens, causing hemolysis. These antibodies pass actively through the placenta, thus generating complications both in the intrauterine period and in the postnatal period. After birth, the biggest complication is hyperbilirubinemia, with a risk of neurotoxicity. Phototherapy is highly effective to control this hyperbilirubinemia, but in extreme cases exchange transfusions may be necessary, an invasive procedure with risks of morbidity and mortality. In 2006, the Fernandes Figueira Institute started the use of prophylactic phototherapy in order to standardize the therapy in newborns with perinatal hemolytic disease by RhD. Objective: To describe the results of prophylactic phototherapy in the clinical evolution of newborns with perinatal hemolytic disease by the RhD antibody, with special attention to the incidence of exchange transfusions. Methods: A retrospective cohort study was performed. Rh positive newborns with positive direct Coombs, children of RhD negative mothers, alloimmunized for the RhD antigen, born between January 2009 and December 2018 were selected. Results: 199 newborns were included in the study. The mean maximum value of bilirubin found was 11.33 mg ±4.26mg, reaching the maximum peak of bilirubin with a mean of 119.23 hours of life (±70.57h); and 9.5% required exchange transfusion. The median time of use of phototherapy was 6 days (IQR: 5-7) with a median of 8 days (IQR: 6-11) of hospital stay. In 32.2% of cases there was hypothermia as a complication of phototherapy. There were 3 deaths, in preterm newborns, born due to acute fetal distress. Conclusion: In this study, a low incidence of exchange transfusion was found. It is possible to observe that the maximum bilirubin peak occurred at later times and that low values of maximum bilirubin were found. However, despite the potential benefit, further studies are needed to obtain more reliable data on the impact of prophylactic phototherapy on newborns in the short and medium term.

Age as A Predictor of Embryo Quality Regardless of The Quantitative Ovarian Response.

BACKGROUND: One determining factor of a successful in vitro fertilization (IVF) cycle is embryo quality. The aim of the present study was to evaluate associations of embryo quality and reserve markers like age, FSH and AMH. MATERIALS AND METHODS: In this prospective study, 120 infertile women, aged 21-44 years, undergoing routine exploration during an unstimulated cycle preceding assisted reproductive technology (ART) at our center were studied prospectively, from February 2011 to December 2014. Descriptive parameters and patient characteristics were reported as mean (SD) or median (range) depending on the distribution. Student's t test was performed for continuous variables, Wilcoxon and Pearson's Test were used for not distributed variables and Fisher's Test was performed for categorical variables. P<0.05 was considered statistically significant. RESULTS: Overall, at the time of investigation, patients had a mean age of 33.03 ± 4.15 years old. On cycle day three, serum anti-Mullerian hormone (AMH) level was 3.50 ± 1.54 ng/mL, serum follicle-stimulating hormone (FSH) level was 6.29 ± 1.53 mUI/ mL, at baseline, women had 16.57 ± 7.0 antral follicles. The mean of collected oocytes was 11.80 ± 5.25, embryo I+II was 2.46 ± 2.11. A greater number of embryos I+II was observed in young patients. By evaluating 120 patients, a significant relationship was observed between age and FSH (r=0.24, P=0.01), age with AMH (r=-0.22, P=0.02), age with collected oocytes (r=-0.23, P=0.03) and age with embryo I+II (r=-0.22, P=0.03). A significant relationship was also observed between antral follicle count (AFC) and AMH (r=0.29, P=0.01), AFC and the number of transferred embryo (r=-0.18, P=0.03), AFC and total dose of the drugs (r=-0.23, P=0.03). Significant relationship of FSH with total dose of drugs (r=0.19, P=0.02) was also observed. In addition, we determined significant relationships between AMH and the number of collected oocytes (r=0.38, P=0.01), AMH and the number of metaphase II oocytes (r= 0.35, P=0.01), AMH and the number of embryo (r=0.19, P=0.04) as well as AMH and total dose of the drugs (r=-0.25, P=0.01). CONCLUSION: Commonly used clinical markers of ovarian reserve are reflection of the ovarian reserve, while the outcome measurements of ART and age are the best predictors of embryo quality.

Avaliação da presença de cuidador familiar de idosos com déficits cognitivo e funcional residentes em Belo Horizonte-MG / Evaluation of the presence of family caregivers of elderly with cognitive and functional deficits living in Belo Horizonte-MG, Brazil

OBJETIVO: Detectar a população idosa com declínio cognitivo e funcional moradora da região abrangida por uma unidade básica de saúde UBS em Belo Horizonte-MG, descrever seu perfil sociodemográfico e avaliar a presença de cuidador familiar. MÉTODO: Estudo transversal a partir de pesquisa do Programa de Educação pelo Trabalho em Saúde PET-Saúde, na Linha de Cuidados de Saúde do Idoso. Do total da amostra, foram selecionados para análise idosos com escore do Miniexame do Estado Mental MEEM menor que 18, totalizando 91 indivíduos. As variáveis sociodemográficas analisadas foram idade, gênero, renda, escolaridade, morar sozinho e ter cuidador familiar. Também foi analisada a força de preensão manual. RESULTADOS: 25% dos idosos entrevistados apresentaram MEEM menor que 18. Destes, 80% eram mulheres; as idades variaram entre 60 e 96 anos; 12% moravam sozinhos; 85% não tinham cuidador familiar. No geral, apresentaram baixos graus de instrução e renda; 52,31% dos que foram submetidos à medida de força de preensão manual podem ser considerados pré-frágeis. CONCLUSÃO: A maioria dos idosos deste estudo não possui cuidador familiar, além disso, há idosos com déficit cognitivo e funcional morando sozinhos.

OBJECTIVE: Detect elderly with cognitive and functional decline living in the area covered by a basic health unit BHU in Belo Horizonte-MG, Brazil, describe their profile and assess the presence of family caregivers. METHOD: Cross-sectional study from research of Programa de Educação pelo Trabalho em Saúde PET-Saúde, in the área of Elderly Health Care. From the whole sample, were selected for analysis elderly individuals with Mini-Mental State Examination MMSE less than 18, totaling 91 individuals. We analyzed age, gender, income, education, grip strength, living alone and having family caregiver. RESULTS: 25% of the subjects interviewed had MMSE less than 18. Among these, 80% were women, ages ranged between 60 and 96 years, 12% lived alone, 85% had no family caregiver. Overall, they had low levels of education and income; 52.31% of those who underwent handgrip strength measurement can be considered pre-frail. CONCLUSION: Most elderly in this study do not have family caregivers, in addition, there are elderly with cognitive and functional deficits living alone.

The level of ascorbate peroxidase is enhanced in benznidazole-resistant populations of Trypanosoma cruzi and its expression is modulated by stress generated by hydrogen peroxide.

Ascorbate peroxidases (APX) are class I heme-containing enzymes that convert hydrogen peroxide into water molecules. The gene encoding APX has been characterized in 11 strains of Trypanosoma cruzi that are sensitive or resistant to benznidazole (BZ). Bioinformatic analysis revealed the presence of two complete copies of the T. cruzi APX (TcAPX) gene in the genome of the parasite, while karyotype analysis showed that the gene was present in the 2.000-kb chromosome of all of the strains analyzed. The sequence of TcAPX exhibited greater levels of similarity to those of orthologous enzymes from Leishmania spp than to APXs from the higher plant Arabidopsis thaliana. Northern blot and real-time reverse transcriptase polymerase chain reaction (RT-PCR) analyses revealed no significant differences in TcAPX mRNA levels between the T. cruzi strains analyzed. On the other hand, Western blots showed that the expression levels of TcAPX protein were, respectively, two and three-fold higher in T. cruzi populations with in vitro induced (17 LER) and in vivo selected (BZR) resistance to BZ, in comparison with their corresponding susceptible counterparts. Moreover, the two BZ-resistant populations exhibited higher tolerances to exogenous hydrogen peroxide than their susceptible counterparts and showed TcAPX levels that increased in a dose-dependent manner following exposure to 100 and 200 µM hydrogen peroxide.

The level of ascorbate peroxidase is enhanced in benznidazole-resistant populations of Trypanosoma cruzi and its expression is modulated by stress generated by hydrogen peroxide

Ascorbate peroxidases (APX) are class I heme-containing enzymes that convert hydrogen peroxide into water molecules. The gene encoding APX has been characterized in 11 strains of Trypanosoma cruzi that are sensitive or resistant to benznidazole (BZ). Bioinformatic analysis revealed the presence of two complete copies of the T. cruzi APX (TcAPX) gene in the genome of the parasite, while karyotype analysis showed that the gene was present in the 2.000-kb chromosome of all of the strains analyzed. The sequence of TcAPX exhibited greater levels of similarity to those of orthologous enzymes from Leishmania spp than to APXs from the higher plant Arabidopsis thaliana. Northern blot and real-time reverse transcriptase polymerase chain reaction (RT-PCR) analyses revealed no significant differences in TcAPX mRNA levels between the T. cruzi strains analyzed. On the other hand, Western blots showed that the expression levels of TcAPX protein were, respectively, two and three-fold higher in T. cruzi populations with in vitro induced (17 LER) and in vivo selected (BZR) resistance to BZ, in comparison with their corresponding susceptible counterparts. Moreover, the two BZ-resistant populations exhibited higher tolerances to exogenous hydrogen peroxide than their susceptible counterparts and showed TcAPX levels that increased in a dose-dependent manner following exposure to 100 and 200 µM hydrogen peroxide.

Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008).

CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients' age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.

Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) / Mudanças nas taxas de mastectomia em um hospital público brasileiro ao longo de 20 anos (1989 a 2008)

CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients' age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.

CONTEXTO E OBJETIVO: Recentemente, a cirurgia conservadora tem substituído a mastectomia para tratamento cirúrgico do câncer de mama. O objetivo deste estudo é avaliar as mudanças nas taxas de mastectomia e cirurgia conservadora e os fatores relacionados a essas mudanças. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo em hospital público brasileiro. MÉTODOS: Dados patológicos das pacientes submetidas a cirurgia para câncer de mama no Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), de 1989 a 2008, foram revistos. As taxas de mastectomia e cirurgia conservadora foram calculadas. O teste qui-quadrado foi usado para avaliar fatores relacionados ao tipo de tratamento cirúrgico empregado e comparar tendências de tipo de tratamento ao longo dos anos. Regressão logística foi usada para análise multivariada. RESULTADOS: De 1989 a 2008, 2.050 espécimes cirúrgicos de câncer de mama foram recebidos em nosso serviço, correspondentes a 1.973 pacientes; 1.324 (64,6%) correspondentes a mastectomia e 726 (35,4%) correspondentes a cirurgia conservadora. A cirurgia conservadora se tornou mais frequente ao longo dos anos (P < 0,001). Em análise multivariada, ano mais precoce da cirurgia (P < 0,001), maior tamanho tumoral (P < 0,001), ter ao menos um linfonodo axilar positivo (P < 0,001) e idade maior de 68 anos (P = 0,007) foram preditores de mastectomia. CONCLUSÕES: As cirurgias conservadoras se tornaram mais frequentes em relação às mastectomias ao longo dos anos. Isso pode refletir a consolidação da cirurgia conservadora (associada a radioterapia) como equivalente à mastectomia em termos de sobrevida, bem como diagnóstico mais precoce da doença.