Nutritional profile of cancer patients treated at an outpatient oncology center in the south region of Brazil

To evaluate the nutritional profile of cancer patients treated at an oncology center in South Brazil.This is a descriptive, exploratory and sectional study that was developed in a process that involved 100 patients aged between 18 and 75 years old, suffering from cancer.The anthropometric variables studied were weight, height, Body Mass Index (BMI), arm circumference (AC), arm muscle circumference (AMC),triceps skinfold (TSF) and corrected arm muscle area (cAMA). For subjective nutritional assessment, we used the Patient-Generated Subjective Global Assessment (PG-SGA). Nearly half of the patients evaluated had a critical need for nutritional intervention. There was a statistically significant association between cAMA and marital status, age and gender; between AC and age, gender and staging; between AMC and staging; between BMI and marital status and age; and between TSF and marital status. Patients diagnosed with IV stage had the lowest values for nutritional variables. There was no significant association between nutritional status of patients obtained by the PG-SGA instrument and sociodemographic characteristics. Malnutrition should be diagnosed as soon as possible,aiming at early intervention and improving survival and quality of life. Therefore, early nutritional assessment in cancer patients is required, combining subjective and objective methods.

The Correlation between Hand Grip Strength and Nutritional Variables in Ambulatory Cancer Patients.

Among the methods used in the nutritional assessment of cancer patients, handgrip strength (HGS), an important indicator of malnutrition, was chosen in this study. An observational cross-sectional study with the prospective collection. We analyzed 100 patients from the Oncology Department of Santa Rita Hospital, in Maringá city, Paraná, Brazil. To determine the clinical-pathological staging was used the Cancer Staging Manual. In the objective nutritional assessment, data to calculate Body Mass Index (BMI), arm muscle circumference (AMC), corrected arm muscle area (cAMA) and measurement of HGS were measured. In connection with the subjective method used, a Patient-Generated Subjective Global Assessment (PG-SGA) has been selected. Arm Circumference (AC) presents a significant association with the left hand HGS classification. The right hand HGS does not show a significant correlation with the analyzed variables. However, the results showed that patients with higher left hand HGS tend to present lower PG-SGA and higher AMC. HGS, as a predictor of nutritional vulnerability, has proved superiority for predicting clinical results in cancer patients. However, it requires more studies that investigate other nutritional variables to determine the nutritional risk in this population.

Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study.

BACKGROUND: Breast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education. OBJECTIVE: This study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods. METHODS: The study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention. RESULTS: A total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially "myths and truths," "incidence," "clinical manifestations," and "protective factors." Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events. CONCLUSIONS: The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.

The recurrence of the melanotic neuroectodermal tumour of infancy: an unusual presentation of a rare tumour.

The melanotic neuroectodermal tumour of infancy (MNTI), also known as melanotic progonoma, is a rare neoplasm derived from neural crest cells. Although it is fundamentally benign, the tumour may present a locally aggressive behaviour, characterised by a rapid progression and a destructive invasion of adjacent structures, hence causing deformities. Unfortunately, perhaps due to the low incidence of this type of tumour, the published cases in the literature do not characterise the factors that imply the malignant or recurrent behaviour of the disease, nor the therapy to conduct these cases. Here, we report a rare case of a recurrent benign MNTI, approached unusually with a favourable outcome.

Percepções médicas: o manejo do idoso demenciado na formação acadêmica e promoção da saúde / Physicians´ perceptions: the management of the demented elderly in academic training and health promotion

Objetivou-se analisar a vivência e o conhecimento de profissionais médicos quanto à demência em idosos e as contribuições do tema para a formação acadêmica e promoção da saúde no envelhecimento. Estudo exploratório, qualitativo, realizado entre abril e agosto de 2017 em uma instituição de ensino superior do Paraná. Participaram nove docentes do curso de medicina, das especialidades de geriatria, psiquiatria e neurologia. Os dados foram extraídos a partir de questionário eletrônico semiestruturado e submetidos à análise lexicográfica através do software IRaMuTeQ® à luz da Práxis Freiriana. A similitude destacou quatro zonas centrais com os elementos diagnóstico, familiar, processo e médico. A nuvem de palavras realçou vocábulos referentes à abordagem da demência no ambiente acadêmico durante a graduação. As percepções profissionais configuram ferramenta importante para melhor explorar os conhecimentos e práticas gerontogeriátricas em módulos teóricos e ambientes práticos de aprendizagem, sendo estímulo a intervenções promotoras e preventivas de saúde

The experience and knowledge of medical professionals regarding dementia in elderly people are analyzed, coupled to the contributions of the theme in academic formation and health promotion in aging people. Current exploratory and qualitative study was conducted between April and August 2017 in a higher education institution of the state of Paraná, Brazil. Nine faculty members of the medical course, specializing in geriatrics, psychiatry and neurology, participated in the study. Data were retrieved from a semi-structured electronic questionnaire and submitted to lexicographic analysis using the IRaMuTeQ® software in the light of Freirian Praxis. Similarity highlighted four central zones featuring diagnostic, familial, process and medical elements. Word cloud highlighted terms referring to the approach of dementia in the academic environment during the undergraduate course. Professional perceptions constitute an important tool to better explore geronto-geriatric knowledge and practices in theoretical modules and practical learning environments, stimulating health promotion and preventive interventions.

Prostatic involvement in disseminated paracoccidioidomycosis: An unusual presentation mimicking malignant neoplasm.

Paracoccidioidomycosis is a granulomatous fungal infection, endemic to Latin America, which has great economic impact. Prostatic involvement is rare and can simulate other conditions, which poses a diagnostic challenge for the clinician. This article describes the report of a case of disseminated paracoccidioidomycosis with prostatic involvement, initially confused with prostatic adenocarcinoma. We hope to contribute to the knowledge of this presentation as a differential diagnosis and reinforce the importance of thorough clinical investigation.

Meu Sonho É Ser Compreendido: Uma Análise da Interação Médico-Paciente Surdo durante Assistência à Saúde / My Dream Is To Be Understood: an Analysis of the Doctor-Deaf Patient Interaction during Health Care

Resumo: Introdução: A comunidade surda representa uma importante parcela da população brasileira que enfrenta inúmeras barreiras na acessibilidade à saúde. Falhas de comunicação aumentam as chances de diagnósticos equivocados, erros de prontuário, constrangimentos, não adesão ao tratamento, sofrimento e insatisfação do usuário. Este estudo teve como objetivos caracterizar os atendimentos de saúde aos surdos, na perspectiva dos profissionais médicos, dos internos de Medicina e dos próprios usuários, e discutir as estratégias desenvolvidas na interlocução e interação médico-paciente e as ferramentas para o aprimoramento da prática médica. Método: Trata-se de um estudo observacional, descritivo, com análise integrada de conteúdo. Participaram da pesquisa 181 indivíduos que foram divididos em três grupos: profissionais médicos (n = 46), graduandos de Medicina da quinta e sexta séries (n = 54) e indivíduos surdos (n = 81). Utilizaram-se dois instrumentos semiestruturados: um para médicos e internos e outro para surdos. Realizou-se uma análise descritiva das variáveis quantitativas com distribuições percentuais para variáveis categóricas e medida de tendência central e dispersão para variáveis numéricas. As respostas das questões dissertativas foram organizadas em três corpus textuais relacionados ao sentimento dos profissionais médicos, internos e surdos durante o atendimento. Em seguida, o material foi submetido à análise lexicográfica com auxílio do software IRaMuTeQ. Resultado: Dentre os médicos e acadêmicos, 76% afirmaram que já atenderam um paciente com surdez grave parcial ou severa. Embora 49% dos surdos tenham afirmado que já sentiram algum desconforto e também alguma segurança no atendimento, 55,5% mencionaram que já deixaram de ir ao médico por medo de não serem compreendidos ou relataram algum problema, como dor, desconforto ou angústia. A participação de acompanhantes como mediadores da relação médico-paciente foi a estratégia mais apontada por todos os participantes. Entre os entrevistados surdos, outras estratégias frequentes mencionadas foram leitura labial e Libras; no caso dos médicos, mímica e escrita; em relação aos internos, leitura labial e escrita. Todas as estratégias não são resolutivas. Conclusão: As percepções dos diferentes atores da interação médico-paciente analisados mostraram diferença de satisfação com o serviço e riscos à saúde dos surdos, o que significa que falta planejamento multimodal com estratégias de comunicação efetivas.

Abstract: Introduction: The deaf community represents a significant portion of the Brazilian population that faces numerous barriers in access to health care. Communication failures increase the chances of misdiagnosis, errors in medical records, embarrassment, non-adherence to treatment, suffering and user dissatisfaction. The study aimed to characterize health care for deaf people from the perspective of medical professionals, medical interns and the patients themselves, discussing the strategies developed in the dialogue and physician-patient interaction, and the tools for the improvement of medical practice. Method: An observational, descriptive study based on integrated content analysis. A sample of 181 participants divided into three groups: medical professionals (n=46), medical students from the fifth and sixth year (n=54) and deaf individuals (n=81). Two semi-structured instruments were used, one for doctors and interns and one for the deaf. Descriptive analysis of the quantitative variables was performed with percentage distributions for categorical variables and measure of central tendency and dispersion for numerical variables. The answers to the essay questions were organized into three groups of texts and the material was submitted to lexicographic analysis with the support of IRaMuTeQ software. Results: 76% of doctors and academics said they had already treated a patient with severe or partial deafness. Although 49% reported discomfort, but also feeling secure when treating deaf patients, 55.5% of the deaf said they had already stopped going to the doctor, or reporting any problems, such as pain, discomfort or anguish, for fear of not being understood. The participation of caregivers as mediators of the doctor-patient relationship was the most frequent communicational strategy pointed out by all participants. Other frequent strategies identified by the deaf interviewees were lip reading and LIBRAS; by the doctors, mime and writing; and by the interns, lip reading and writing; all of which are non-resolving strategies. Conclusions: The perceptions of the different actors of the doctor-patient interaction analyzed showed differences in satisfaction with the service and health risks for the deaf, lacking multimodal planning with effective communication strategies.

Avaliação da Qualidade de Vida e Prevalência de Sintomas Depressivos em Pacientes Oncológicos Submetidos à Radioterapia / Assessment of Quality of Life and Prevalence of Depressive Symptoms in Oncologic Patients submitted to Radiotherapy / Evaluación de la Calidad de Vida y Prevalencia de Síntomas Depresivos en Radioterapia en Pacientes Oncológicos

Introdução: A qualidade de vida de pacientes oncológicos tem sido objeto de estudo em muitos trabalhos brasileiros. Contudo, apesar da alta prevalência de indivíduos submetidos à radioterapia, poucos estudos com ênfase nesse grupo de pacientes foram identificados. Objetivo: Avaliar a qualidade de vida e a prevalência de sintomas depressivos em pacientes com neoplasias malignas durante o tratamento radioterápico. Método: Estudo transversal quantitativo realizado com 153 pacientes oncológicos em vigência de tratamento radioterápico em um centro especializado em oncologia e radioterapia, localizado no Noroeste do Estado do Paraná. Os dados foram coletados entre março e setembro de 2018. O European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) e o Inventário de Depressão de Beck foram utilizados para avaliar a qualidade de vida e os sintomas depressivos, respectivamente. Resultados: Os domínios "qualidade de vida", "função cognitiva" e "função social" foram os que menos se mostraram prejudicados na amostra estudada, enquanto "insônia", "perda de apetite" e "dificuldades financeiras" destacaram-se entre os maiores preditores de baixa qualidade de vida. Ademais, contatou-se que 22% dos indivíduos avaliados apresentaram algum grau de transtorno de humor, sendo 11% diagnosticados com depressão. Conclusão: O declínio na qualidade de vida e a prevalência de sintomas depressivos em pacientes oncológicos, mesmo os em vigência de radioterapia, enaltecem a importância de intervenções precoces que visem a restabelecer a funcionalidade e o bem-estar.

Introduction: The quality of life of cancer patients has been studied in many Brazilian papers. However, despite the high prevalence of individuals undergoing radiotherapy, few studies with emphasis in this group of patients have been identified. Objective: To evaluate the quality of life and the prevalence of depressive symptoms in patients with malignant neoplasms undergoing radiotherapy treatment. Method: Quantitative cross-sectional study with 153 cancer patients undergoing radiotherapy treatment at an oncology and radiotherapy specialized center, located in the northwest of Paraná state. Data were collected between March and September 2018. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Beck Inventory were used to assess quality of life and depressive symptoms, respectively. Results: The domains "quality of life", "cognitive function" and "social function" were the least affected in the studied sample, while "insomnia", "loss of appetite" and "financial difficulties" stood out among the higher predictors of poor quality of life. In addition, it was found that 22% of the individuals evaluated had some degree of mood disorder, 11% being diagnosed with depression. Conclusion: The decline in quality of life and the prevalence of depressive symptoms in cancer patients, even those undergoing radiotherapy, emphasize the importance of early interventions aimed at restoring functionality and well-being.

Introducción: La calidad de vida de los pacientes con cáncer se ha estudiado en muchos estudios brasileños. Sin embargo, a pesar de la alta prevalencia de individuos sometidos a radioterapia, se han identificado pocos estudios con énfasis en este grupo de pacientes. Objetivo: Evaluar la calidad de vida y la prevalencia de síntomas depresivos en pacientes con neoplasias malignas sometidas a radioterapia. Método: Estudio transversal cuantitativo realizado con 153 pacientes con cáncer sometidos a tratamiento de radioterapia en un centro especializado en oncología y radioterapia, ubicado en el Noroeste del Estado de Paraná. Los datos se recopilaron entre marzo y septiembre de 2018. El European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) y el Inventario Beck se utilizaron para evaluar la calidad de vida y los síntomas depresivos, respectivamente. Resultados: Los dominios "calidad de vida", "función cognitiva" y "función social" fueron los menos afectados en la muestra estudiada, mientras que el "insomnio", la "pérdida de apetito" y las "dificultades financieras" se destacaron entre los dominios. predictores más altos de mala calidad de vida. Además, se encontró que el 22% de los individuos evaluados tenían algún grado de trastorno del estado de ánimo, y el 11% fue diagnosticado con depresión. Conclusión: La disminución de la calidad de vida y la prevalencia de síntomas depresivos en pacientes con cáncer, incluso en aquellos que reciben radioterapia, enfatizan la importancia de las intervenciones tempranas destinadas a restaurar la funcionalidad y el bienestar.

Adesão ao grupo de cessação entre tabagistas de unidade básica de saúde / Adhesión al grupo de abandono entre fumadores en unidad básica de salud / Adherence to a smoking cessation group by smokers assisted at a basic health unit

RESUMO Objetivo: verificar o perfil de usuários tabagistas e compreender os aspectos relacionados à adesão ao grupo de cessação. Método: estudo transversal com tabagistas de uma Unidade Básica de Saúde de Maringá, estado do Paraná. A coleta e a análise descritiva dos dados ocorreram entre agosto e setembro de 2016. Resultados: participaram do estudo 72 tabagistas; 51 desconheciam o Programa Nacional de Controle do Tabagismo e a proposta de grupos de cessação. As barreiras identificadas para a não adesão aos grupos foram dificuldade de locomoção à unidade de saúde e incompatibilidade de horários com a rotina dos tabagistas. Entre os entrevistados, 42 mostraram interesse em participar de intervenção voltada ao controle do tabagismo, sugerindo maior acesso a informações e mudanças na abordagem das atividades. Conclusão: há a necessidade de valorizara busca ativa dos indivíduos na comunidade e abordar dinamicamente os grupos para atender a real necessidade dos participantes. As variáveis levantadas podem contribuir para maior participação de tabagistas no programa e para a cessação do hábito de fumar.

RESUMEN Objetivo: Verificar perfil de fumadores, comprender aspectos relativos a adhesión al grupo de abandono. Método: Estudio transversal con fumadores de Unidad Básica de Salud de Maringá, Paraná. Datos recolectados y analizados descriptivamente de agosto a setiembre de 2016. Resultados: Participaron 72 fumadores; 51 desconocían el Programa Nacional de Control del Tabaquismo y la propuesta de grupos de abandono. Se identificaron como barreras para la no adhesión: dificultad de traslado a la unidad de salud e incompatibilidad horaria con rutinas de los fumadores. Cuarenta y dos entrevistados estuvieron interesados en participar de intervención orientada al control del tabaquismo, lo que sugiere mayor acceso a información y cambios de abordaje de las actividades. Conclusión: Es necesario valorar la búsqueda activa de los individuos de la comunidad y atender las necesidades reales de los participantes. Las variables relevadas favorecen mayor participación de fumadores en el programa y para abandonar el hábito de fumar.

ABSTRACT Objective: to analyze the profile of smokers assisted at a basic health unit and understand the aspects related to adherence to a smoking cessation group. Method: Cross-sectional study with smokers assisted at a Basic Health Unit in Maringá in the State of Paraná. Data collection and descriptive analysis were performed in August-September 2016. Results: Seventy-two (72) smokers participated in the study. Of these, 51 were unaware of the National Tobacco Control Program (PNCT) and the proposed cessation groups. The barriers to adherence to the intervention groups identified in this study were difficult access (transportation) to the health unit and inability to join the groups due to the smokers' routine. Forty-two (42) respondents were willing to participate in a group intervention targeted to tobacco control and said that greater access to information and changes in the approaches used in these interventions were necessary. Conclusion: active search of the individuals in the community and use of a dynamic approach in group interventions are needed to meet the real needs of the participants. The variables identified may contribute to increase the participation of smokers in the program and, hence, smoking cessation rates.