Maternal Risk Factors Associated with Negative COVID-19 Outcomes and Their Relation to Socioeconomic Indicators in Brazil.

BACKGROUND: This study aimed to analyze maternal risk factors associated with negative outcomes of COVID-19 and association with socioeconomic indicators in Brazil. METHODS: A cross-sectional study, with data from the Influenza Epidemiological Surveillance Information System (SIVEP-Flu) of pregnant women with COVID-19 and cases of hospitalization and death. For the analysis of risk factors and outcomes, the multiple logistic regression method was used. RESULTS: Pregnant women who had some risk factor represented 47.04%. The chance of death was 2.48 times greater when there was a risk factor, 1.55 for ICU admission and 1.43 for use of ventilatory support. The percentage of cure was 79.64%, 15.46% without any negative outcome, 4.65% death and 0.26% death from other causes. Pregnant women who did not take the vaccine represented 30.08%, 16.74% took it and 53.18% were not specified. The variables HDI, illiteracy, per capita income and urbanization did not influence the cases of COVID-19. CONCLUSIONS: Factors such as age, obesity, asthma and pregnancy were responsible for the increase in hospitalizations, respiratory complications and death. Vaccination reduced the risk of negative outcomes by 50%. There were no correlations between socioeconomic indicators and the negative outcomes of COVID-19 in pregnant women.

Desenvolvimento de ferramenta para a triagem de dengue e COVID-19 na atenção primária à saúde / Development of a tool for the screening of dengue and COVID-19 in primary health care / Desarrollo de una herramienta para el tamizaje de dengue y COVID-19 en la atención primaria de salud

Introdução: A distinção entre dengue e COVID -19 é um desafio, já que ambas as doenças compartilham semelhanças clínicas e laboratoriais, e os sintomas nos quadros infecciosos podem levar a diagnósticos incorretos em seu atendimento inicial. Objetivo:Desenvolver ferramenta para triagem de pacientes com sintomatologia de dengue e/ou COVID-19. Método:Pesquisa tecnológica, com vertente quantitativa, descritiva e exploratória. Possui duas etapas de produção. Utilizou-se referencial teórico para a construção da ferramenta, além dos dados da pesquisa os protocolos do Ministério da Saúde. Resultados:Participaram 36 pessoas das quais, 24 tiveram Dengue em que 50% apresentaram como sintomas -mialgia (83%), cefaleia (79%), mal-estar (75%), exantemas (71%), febre (71%), dor retro orbital (63%), coceira (54%), artralgia e falta de apetite (50%). Quanto aos sintomas da covid-19, 7 tiveram a doença e mais de 50% das pessoas apresentaram febre (75%), dor na garganta (75%), perda de olfato e paladar e mialgia (63%). Após a coleta de dados, a ferramenta tecnológica foi desenvolvida em 3 passos: anamnese, exame físico e encaminhamento do paciente. Conclusão:Observou-se que os sintomas: mialgia, artralgia, cefaleia, perda de paladar, náuseas, vômitos, diarreias, dor retro orbitária e fadiga foram comuns para pacientes COVID -19 e aqueles diagnosticados com dengue. O instrumento foi considerado norteador para a triagem desses sintomas comuns a ambas as doenças pelos enfermeiros na Atenção Primária à Saúde.

Introduction: Distinguishing between dengue and COVID-19 is a challenge, as both diseases share clinical and laboratory similarities, and symptoms in infectious conditions can lead to incorrect diagnoses in their initial care. Objective: To develop a tool for screening patients with symptoms of dengue and/or COVID-19. Method: Technological research, with a quantitative, descriptive and exploratory aspect. It has two production stages. Theoretical framework was used for the construction of the tool, in addition to the research data, the protocols of the Ministry of Health. Results: Thirty-six people participated, of which 24 had Dengue in which 50% had symptoms -myalgia (83%), headache (79%), malaise (75%), rash (71%), fever (71%), retro orbital pain (63%), itching (54%), arthralgia and lack of appetite (50%). As for the symptoms of covid-19, 7 had the disease and more than 50% of people had fever (75%), sore throat (75%), loss of smell and taste and myalgia (63%). After data collection, the technological tool was developed in 3 steps: anamnesis, physical examination and patient referral. Conclusion: It was observed that the symptoms: myalgia, arthralgia, headache, loss of taste, nausea, vomiting, diarrhea,retro orbital pain and fatigue were common for COVID-19 patients and those diagnosed with dengue. The instrument was considered a guide for the screening of these symptoms common to both diseases by nurses in Primary Health Care.

Introducción: Distinguir entre dengue y COVID-19 es un desafío, ya que ambas enfermedades comparten similitudes clínicas y de laboratorio, y los síntomas en condiciones infecciosas pueden conducir a diagnósticos incorrectos en su atención inicial. Objetivo: Desarrollar una herramienta para el tamizaje de pacientes con síntomas de dengue y/o COVID-19. Método: Investigación tecnológica, con aspecto cuantitativo, descriptivo y exploratorio. Tiene das etapas de producción. Se utilizó marco teórico para la construcción de la herramienta, además de los datos de la investigación, los protocolos del Ministerio de Salud. Resultados: Participaron 36 personas, de las cuales 24 padecían Dengue de las cuales el 50% presentaba síntomas -mialgia (83%), cefalea (79%), malestar general (75%), exantema (71%), fiebre (71%), dolor retroorbitario (63%), prurito (54%), artralgia y falta de apetito (50%). En cuanto a los síntomas de covid-19, 7 tenían la enfermedad y más del 50% de las personas tenían fiebre (75%), dolor de garganta (75%), pérdida del olfato y del gusto y mialgia (63%). Después de la recolección de datos, la herramienta tecnológica se desarrolló en 3 pasos: anamnesis, examen físico y derivación del paciente. Conclusión: Se observó que los síntomas: mialgia, artralgia, dolor de cabeza, pérdida del gusto, náuseas, vómitos, diarrea, dolor retroorbitario y fatiga fueron comunes para los pacientes con COVID-19 y los diagnosticados con dengue. El instrumento fue considerado una guía para el tamizaje de estos síntomas comunes a ambas enfermedades por parte de los enfermeros en la Atención Primaria de Salud.

Colorectal cancer mortality in women: trend analysis in Brazil and its regions and states.

OBJECTIVES: to analyze colorectal cancer mortality trends in women in Brazil and its regions and states. METHODS: ecological, time-series study with trend analysis of deaths caused by colorectal cancer in women in Brazil and its regions and states between 2008 and 2019. Polynomial regression was used to treat the data. RESULTS: 48,225 deaths of women caused by colorectal cancer were examined. There was an increasing mortality trend in Brazilian women, with regional differences that resulted from socioeconomic, political, and cultural inequalities. The South Region stood out with the highest rate (7.32) in 2008, which increased to 8.65 in 2019, followed by the Southeast Region, whose rates were 6.72 and 9.05 in 2008 and 2019, respectively. CONCLUSIONS: colorectal cancer mortality increased, which indicates the need to expand public policies oriented toward screening and early diagnosis of colorectal cancer in women.

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.

Colorectal cancer mortality in women: trend analysis in Brazil and its regions and states / Mortalidad por cáncer colorrectal en mujeres: análisis de tendencia en Brasil, Estados y Regiones / Mortalidade por câncer colorretal em mulheres: análise de tendência no Brasil, Estados e Regiões

ABSTRACT Objectives: to analyze colorectal cancer mortality trends in women in Brazil and its regions and states. Methods: ecological, time-series study with trend analysis of deaths caused by colorectal cancer in women in Brazil and its regions and states between 2008 and 2019. Polynomial regression was used to treat the data. Results: 48,225 deaths of women caused by colorectal cancer were examined. There was an increasing mortality trend in Brazilian women, with regional differences that resulted from socioeconomic, political, and cultural inequalities. The South Region stood out with the highest rate (7.32) in 2008, which increased to 8.65 in 2019, followed by the Southeast Region, whose rates were 6.72 and 9.05 in 2008 and 2019, respectively. Conclusions: colorectal cancer mortality increased, which indicates the need to expand public policies oriented toward screening and early diagnosis of colorectal cancer in women.

RESUMEN Objetivos: analizar las tendencias de mortalidad por cáncer colorrectal de mujeres en Brasil, Estados y Regiones. Métodos: estudio ecológico, de series temporales, con análisis de tendencia de decesos por cáncer colorrectal en mujeres, entre 2008 y 2019. Para análisis de tendencia se utilizó el modelo de regresión polinomial. Resultados: se analizaron 48.225 decesos de mujeres por cáncer colorrectal. Se observó tendencia creciente de mortalidad en las mujeres brasileñas, con diferencias regionales debidas a desigualdades de estándares socioeconómicos, políticos y culturales. Se manifiesta un aumento en la Región Sur, con tasa de 7,32 en 2008 incrementando a 8,65 en 2019, siguiéndole la Región Sudeste, con tasas de mortalidad de cáncer colorrectal de 6,72 y 9,05 en 2008 y 2019. Conclusiones: se observa aumento de tasas de mortalidad por cáncer colorrectal, demostrándose necesidad de incrementar las políticas públicas orientadas a estrategias de rastreo y diagnóstico precoz del cáncer colorrectal en mujeres.

RESUMO Objetivos: analisar as tendências da mortalidade por câncer colorretal em mulheres no Brasil, Estados e Regiões. Métodos: estudo ecológico, de séries temporais, com análise de tendência dos óbitos por câncer colorretal de mulheres, no período de 2008 a 2019. Para análise de tendência, foi utilizado o modelo de regressão polinomial. Resultados: analisaram-se 48.225 óbitos de mulheres por câncer colorretal. Houve tendência crescente da mortalidade em mulheres brasileiras, com diferenças regionais, em razão das desigualdades nos padrões socioeconômicos, políticos e culturais. Destacando um aumento na Região Sul, com as maiores taxas, de 7,32 em 2008 para 8,65 em 2019, seguida pela Região Sudeste, com taxas de mortalidade por câncer colorretal de 6,72 e 9,05 em 2008 e 2019, respectivamente. Conclusões: observa-se um aumento das taxas de mortalidade por câncer colorretal, demonstrando a necessidade do incremento das políticas públicas direcionadas às estratégias de rastreamento e diagnóstico precoce do câncer colorretal em mulheres.

Impact of the Covid-19 Pandemic on Women's Health in Brazil.

PURPOSE: The aim is to verify the impact of the Covid-19 pandemic on women's healthcare and medical assistance in Brazil. PATIENTS AND METHODS: This exploratory cross-sectional study evaluated a non-probabilistic sample of women above 20 years old, carried out between August and September of 2020, through a snowball sampling using a Google Forms application. RESULTS: From a total of 2495 women, more than 70% have not been screened for cervical cancer (77.8% of 2244 women aged for screening), and more than 80% have not been screened for breast cancer (80.2% from 1325 women aged for mammography) during the pandemic. Also, 55.2% of the women did not undergo routine blood tests during the same period. The most frequent reasons for not performing screening and routine tests were: they were up to date; fear of contracting Covid-19; they decided to postpone it until after the end of the pandemic; they were unable to schedule the appointment at the healthcare center for whatever reason; and the healthcare center was only attending Covid-19 patients. Women with no comorbidities have performed significantly more mammograms and routine blood tests than women with comorbidities. In addition, women with comorbidities who were used to perform periodic medical follow-up have done it substantially more than women with no comorbidities during the pandemic. CONCLUSION: As observed, there was a significant decrease in women's access to the healthcare system during this pandemic. Many participants reported that they had not attended any screening tests, and some reasons included fear of getting infected and due to the public measures of social distancing. The consequences are late diagnoses and a worse prognosis. It might impact the healthcare systems around the world in the next few years. Further studies should be done to follow these consequences.

Fatores relacionados à adesão ao tratamento farmacológico por idosos na Atenção Primária à Saúde / Factors related to adhesion to pharmacological treatment by seniors in Primary Health Care

Objective: To identify factors related to adherence to pharmacological treatment by the elderly people in Primary Health Care.Method: It is a descriptive study developed with a team of the Family Health Strategy, in a municipality in northwestern Paraná. Data were collected in June and July 2018, through a questionnaire applied at home visit. Subsequently, the data were recorded, organized in spreadsheets and submitted to descriptive statistics.Results: Among the 118 elderly participants, 61.1% were female, 78.8% were between 60 and 69 years old, 59.3% had up to eight years of schooling, 12.2% had some physical disability, 9, 7% needed help to use medication, 60.1% were taking medication as prescribed, 12.1% had already used medication changed, 39.8% used 1 to 3 medications prescribed by the doctor, 50% reported Self-medication, 84.7% reported knowledge of the indication of all medications, 5.1% indicated that the greatest difficulty in adhering to treatment is that the medication is not provided free of charge. Conclusion: Given the factors highlighted by the participants as influential in adherence to drug treatment, it is necessary that professionals and managers jointly establish strategies to facilitate access to the necessary drugs for seniors.

Objetivo: identificar os fatores relacionados à adesão ao tratamento farmacológico por idosos na Atenção Primária à Saúde. Método: Estudo descritivo desenvolvido junto a uma equipe da Estratégia Saúde da Família, em um município do noroeste do Paraná. Os dados foram coletados nos meses de junho e julho de 2018, por meio de questionário aplicado no momento da visita domiciliar. Posteriormente, os dados foram registrados, organizados em planilhas e submetidos à estatística descritiva. Resultados: Dentre os 118 idosos participantes, 61,1% eram do sexo feminino, 78,8% tinham entre 60 e 69 anos, 59,3% possuíam até oito anos de estudo, 12,2% apresentavam alguma deficiência física, 9,7% necessitavam de auxílio para utilizar medicamentos, 60,1% faziam uso da medicação conforme prescrição médica, 12,1% já fez uso de medicamento trocado, 39,8%, utilizavam de 1 a 3 medicamentos prescritos pelo médico, 50% relataram automedicação, 84,7% relataram conhecimento da indicação de todos os medicamentos, 5,1% indicaram que a maior dificuldade para aderir ao tratamento é o medicamento não ser fornecido gratuitamente. Conclusão: Diante dos fatores destacados pelos participantes como influentes na adesão ao tratamento medicamentoso, torna-se necessário que profissionais e gestores estabeleçam conjuntamente estratégias para facilitar o acesso aos medicamentos necessários para os idosos.

Comparative Analysis between the Gail, Tyrer-Cuzick and BRCAPRO Models for Breast Cancer Screening in Brazilian Population.

OBJECTIVE: To analyze the diagnostic accuracy of predictive models of breast cancer risk for the Brazilian population. METHOD: A cross-sectional, study was conducted in a sample of 382 women aged 35-69 years who were users of the Unified Health System (SUS) residing in a municipality in southern Brazil. RESULTS: The results showed that the Tyrer-Cuzick model had the highest mean risk values and estimates (proportion) for predicting the 5-year risk of breast cancer, reaching a maximum risk of ±1.63% in the 60-64 year age group. For the 90-year risk, a maximum risk of ±12.8% was predicted for the 50-54 year age group using this model. The 5-year risk calculated by the three tools increased progressively with increasing age, where the mean risk was ±0.8% in women aged 35-39 and reached ±1.50% in women aged 65-69. The 90-year risk declined with increasing age only in the Tyrer-Cuzick model, from ±10.8% to ±9%. The BRCAPRO model presented a greater sensitivity compared to the Gail and Tyrer-Cuzick models. And, the model that presented greater specificity was Gail. CONCLUSION: The Tyrer-Cuzick model presented the highest risk estimates for 5 years and 90 years in the studied population, however, this data is not enough to validate this tool, since when analyzing the sensitivity and specificity the BRCAPRO and Gail have the highest values respectively.

Indicadores de qualidade da assistência de enfermagem na terapia intravenosa periférica / Indicators of quality of nursing assistance in peripheral intravenous therapy

Objetivo: verificar os indicadores de qualidade da assistência de Enfermagem na terapia intravenosa periférica. Método: estudo observacional, descritivo, exploratório, de abordagem quantitativa, realizado em um Hospital Filantrópico no setor de enfermaria masculina e feminina. Para análise dos CVP, verificou-se a identificação da data da punção e/ou validade. Para a análise dos dados, utilizou-se o cálculo de indicadores de qualidade da assistência de Enfermagem. Resultados: foram realizadas 515 observações, o que corresponde a 96,62% em relação às oportunidades e uma média de 25 observação/dia. Obteve-se um indicador de 86,1% de conformidade acerca da identificação do cateter venoso periférico e de 42,5% de identificação de equipo de soro 42,5%. Identificou-se que 40% dos pacientes que estavam fazendo uso de equipo e frascos de soros não atendiam a critérios de segurança. Conclusão: em relação aos indicadores de qualidade da assistência na terapia intravenosa periférica, em especial ao cuidado ao cateter vascular periférico, conclui-se que ainda é um desafio, em especial àqueles que remetem aos cuidados com o soro e controle de velocidade da infusão.