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Item Mulheres com lesões precursoras ou invasivas do colo de útero: a realidade do atendimento no Sistema Único de Saúde(Universidade Federal de Goiás, 2011-08-17) ALBUQUERQUE, Zair Benedita Pinheiro de; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029OBJECTIVE: To investigate whether women with altered cervical cytopathological outcomes have been referred to Medium Complexity Units (MCU) as in accordance with the Brazilian Ministry of Health guidelines, as well analyze the perception of these womens about the attention received and the psychologic aspects that involved the diagnosis and treatment. METHODS: Descriptive, exploratory, quantitative and qualitative study based on the cytopathological outcomes of the BHS users carried out in Basic Health Assistance Units (BHAU) referred to Medium Complex Units (MCU) in the municipality of Goiânia, State of Goiás, 2005/2006. We assessed 1.109 records regarding the Brazilian Ministry of Health/the National Institute of Cancer guidelines as established by the Brazilian Nomenclature for Cervical Outcomes and Preconized Clinical Practice. Data was analyzed and processed by using Epi-info 3.3.2, 2006 and Microsoft Excel 2007. Variables were assessed descriptively, through calculus of relative and absolute frequency. For qualitative analysis, the interview method were used containing the subject caracterization and two guiding questions: one with negative polarity and other with positive polarity. RESULTS: From the total number of referrals, 79% were not in accordance with the Brazilian Ministry of Health guidelines which originated a great number of unnecessary procedures. The qualitive analysis explicitated fails on the professional attendance and in this attendance flow regarding to comunication about the actions relatives to treatment, services humanization and no observations of the established flow. The psycosocial aspects demonstrated that women didn t receive the necessary psicological attention to minorate the feelings of pain, despair, shame and, most of all, fear of death and mutilations. CONCLUSIONS: We observed inadequate referrals to the MCUs, which demanded a big number of unnecessary procedures. In women s perception, the attendence was permeated by fails in the reception, in communication, professional assistence, lack of knowledge about the attendence flow. The psycosocial aspects demand treatment integrality with multiprofessional teams working according to a biopsycosocial model.Item Mamografia: infraestrutura, cobertura, qualidade e risco do câncer radionduzido em rastreamento oportunístico no estado de Goiás(Universidade Federal de Goiás, 2012-04-10) CORRÊA, Rosangela da Silveira; PEIXOTO, João Emilio; http://lattes.cnpq.br/9897171879507189; FREITAS JÚNIOR, Ruffo de; http://lattes.cnpq.br/7343840830786566Among the available methods for the diagnosis and early detection of breast cancer, the most indicated for mass screening is the mammography. To guarantee its effectiveness, this exam needs to be performed using high quality standards and the lowest radiation dose possible. Therefore, the present research aimed to assess the infrastructure and performance of the equipments available at the mammography services in the state of Goiás, regarding coverage, quality, and radiological protection (dose) of patients, in order to provide early detection of breast cancer by an opportunistic screening. A prospective study was carried out, from 2007 to 2010, to observe the diagnostic imaging services which perform mammography, initially for the Brazilian Unified National Health System (SUS) and, in 2010, the services of the private system were included. Data collection was divided into two phases: the first, to collect information on infrastructure and the second, to apply tests in order to evaluate the performance characteristics of equipment and materials used. We calculated the conformity of the assessed items in terms of quality of image and equipment performance and estimated the average dose in glandular tissue and the risk of radioinduced carcinogenesis, as well as the risk of mortality by radioinduced tumors. The results were presented in four articles. In the first, we showed that mammography coverage in the state of Goiás in 2008 was 66% among women in the 50 69-year age group, considering biennial mammography. In the second article, we concluded that the implementation of the Mammography Quality Control Program was effective to achieve better quality mammography in SUS services. In the beginning of our research, only 2.9% of SUS services were within the desired range of quality and, after two interventions (2008 and 2009), 20% of them reached it. The results of the third article, in which we verified the infrastructure and quality of services performing mammography, both for SUS and private systems, showed no difference in quality of exams between them. However, the evaluation between types of technology used showed difference between radiation doses (p < 0.001) applied during mammography. In the fourth article, we estimated the benefit risk balance of screening mammography carried out in the state of Goiás in 2010. The excess absolute risk of radioinduced cancer and the lifetime risk presented significant difference for types of technology (p < 0.001) and types of health system (p < 0.019) according to the age group of screening. The ratio lives saved/lives lost was 75.5/1 for screening at the 40 70-year age group and 166.5/1 at the 50 70-year age group. The results showed that coverage of the 50 69-year age group in the state of Goiás is near the recommended standards for the beginning of organized screenings. However, when assessed per regional health unit, coverage was non-uniform, presenting high concentration of equipments and exames at the Central Regional. The initial evaluation of equipment performance indicated the need to implant actions for controlling mammography quality and risk. The actions of the Mammography Quality Control Program proved to be effective to enhance the quality of mammography, although the same does not remain true for the radiation dose used in mammography. These doses are lower in conventional mammography equipments than in those coupled to image digitization systems. Regarding radiological protection, screening women who are 50 70 years old, when performed biennially using conventional mammography equipments, presented more benefit.Item Qualidade de vida e sintomas depressivos em indivíduos expostos ao Césio-137, em Goiânia(Universidade Federal de Goiás, 2012-10-01) FUINI, Silvana Cruz; AMARAL, Geraldo Francisco do; http://lattes.cnpq.br/1523095487178024; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029Objectives: This study evaluated the Quality-of-Life (QoL) of those individuals exposed to Cesium-137, in Goiânia, Goiás, Brasil and its association with symptoms of depression and socio-demographic factors. Methods: 62 subjects participated, who were divided into two groups: Group I (people with radiodermatitis and / or with cytogenetic desimetry above 20 rads), n=33; Group II (people with cytogenetic desimetry < or =20 rads), n=29.The instrument WHOQL-Bref was applied to evaluate the (QoL) and the scale for Beck Depression Inventory (BDI) for the screening of symptoms of depression. The social-demographic factors were collected through the Monitoring System of Victims of Radiation. Data analysis used the syntax of WHOQOL-BREF using SPSS ® for Windows ® version 15.0. To compare the variables we used the Student's T test and ANOVA. For correlation between WHOQOL-BREF and BDI used the Pearson test. It was considered as significance level value of 5% (p <0.05). Results: Among the areas of WHOQL-Bref, the environment had the highest mean scores (59.02, SD = 20:39) and the psychological had the lowest average (53.02, SD = 20:39). The associations between the physical, psychological and social relationships were significant for the age variable, respectively (p = 0.018, p = 0.002, p = 0.001). For the BDI it was observed that 33.9% of subjects were above the cutoff point (> 16), showing a difference in those over 41 years of age (p> 0.05), all items of the BDI were correlated with all domains of WHOQL-Bref (p = <0.0010). Conclusions: Individuals exposed to cesium-137 suffer considerable impact on their QOL, with persistence of psychosocial problems, especially for those with more than 41 years. BDI results showed that radiation exposure constitutes a risk factor for psychiatric disorders, verifying the presence of significant depressive symptoms, especially in people over 41 years and, to a lesser extent, the members of Group I and distributed among women in both groups. The domains of the WHOQOL-BREF and BDI correlated indicating that QOL and depressive symptoms are constructs with areas of intersection. Sociodemographic factors related to education and religion associated with the results of the assessment of QOL and symptoms of depression.Item Mortalidade por câncer de mama nas mulheres brasileiras no período de 1980 a 2009(Universidade Federal de Goiás, 2011-09-30) GONZAGA, Carolina Maciel Reis; FREITAS, Nilceana Maya Aires; http://lattes.cnpq.br/3872749814487965; FREITAS JÚNIOR, Ruffo de; http://lattes.cnpq.br/7343840830786566Introduction: Breast cancer is the principal cause of death from cancer in women in Brazil and worldwide. Brazil has important social differences, therefore, to understand the mortality rates for female breast cancer, it is necessary to look at the issue of spatial inequalities in income and opportunities characteristic of Brazilian society. Aim: To describe the temporal evolution of breast cancer mortality in Brazil, in its macro-regions and Federal States from 1980 to 2009. Materials and Methods: Ecological time series, using data on deaths from breast cancer registered in the Mortality Information System (SIM/MOH) and the data of population census by the Brazilian Institute of Geography and Statistics (IBGE). Mortality trends analysis was performed using Poisson s regression model. Results: for Brazil it was observed a 0.4% stabilization trend in women breast cancer mortality since 1994 (95% CI -01 0.8; p = 0.08). Southeast regions showed decreasing trends -0.9% (95% CI -1.6 -0.2; p = 0.01), in South it was observed a -0.3% stabilization (95% CI -1.0 0.3; p = 0.31), whereas the Northeast region stands out with a higher 5.3% increasing trends per year (95% CI 3.9 6.7; p <0.01). A significant decreasing mortality trend was observed in São Paulo -1.9% (95% CI -2.9 -0.9; p < 0.01), Rio Grande do Sul -0.8% (95% CI -1.4 -0.1; p = 0.03) and Rio de Janeiro -0.6% (95% CI -1.1 -0.1; p = 0.03). The highest increases in mortality trends were observed in Maranhao 12% (95% CI 2.5 22.3; p < 0.01), Paraiba 11.9% (95% CI 7.3 16.7; p <0.01) and Piaui 10.9% (95% CI 6.3 15.7; p <0.01). Conclusion: Brazil presented a stabilization trend regarding women breast cancer mortality rates, however, when regions and Federal States were analyzed, mortality rates presented unequal, with decreasing trends and stabilization in zone with higher socioeconomic level and higher increasing trends among zone with lower socioeconomic level.Item PREVALÊNCIA DE HEMOGLOBINOPATIAS EM RECÉMNASCIDOS DO MUNICÍPIO DE GOIÂNIA(Universidade Federal de Goiás, 2009-10-20) RUIZ JÚNIOR, Everaldo; ANDRADE, Ana Lúcia Sampaio Sgambatti de; http://lattes.cnpq.br/7770363683068899; COSTA, Paulo Sérgio Sucasas da; http://lattes.cnpq.br/9224543529268366Hemoglobinopathies are the most common inherited disorders in humans; the most frequent are hemoglobins S and C. This study evaluates the prevalence of hemoglobin patterns at the city of Goiânia, state of Goiás, Brazil, using neonatal screennig. Prevalence was compared between exams from the public and private systems. Blood samples from 90,127 newborns were obtained. Hemoglobinopathies were identified in a total of 61 (7:10.000) newborns. The prevalence in public and private systems was 7 and 3 per 10,000 respectively (p=0.081). In 3,243 (371:10,000) hemoglobinopathy traits were detected. The public system´s prevalence was 400:10,000 and in the private system it was 177:10,000 (p=0.0001). The prevalence of sickle cell disease was 4.3:10,000 live birth overall; in the public system, it was 5:10,000 and in the private system it was 2:10,000 (p=0.133). We can conclude that sickle disease is of high prevalence in children at public and private systems. The neonatal screening information is of paramount importance for early diagnosis of sickle disease and people with sickle traits