Humanized care for the oncologic patient: reflections with the health team

The present study is concerning a practice of assistance built and implemented with the health team members of an Oncology and Radiotherapy Service in a large general hospital in the east part of the state of Rio Grande do Sul, attempting to make the assistance more humane. It was a possibility of reflecting with the work team about the assistance provided to the patients in light of the proposals of SUS (New Public Health System) and with the perspective of the humanistic approach and its methodological proposals.     

Opinions of students and educators concerning health: the public school perspective in a peripheral area of the city of São Paulo

This study focused on prevailing concepts in society concerning adolescents' health problems and needs. Based on concerns in the field of Collective Health in relation to public policies for social protection, the study attempted to grasp the public school perspective concerning these issues. The study's theoretical reference was the social determination of the health-disease process and the view that health needs are translated into demands for changes in the harmful processes resulting from relations in the production process. Data were gathered through interviews with pedagogical coordinators and focus groups with adolescents in public schools from the Raposo Tavares School District (Municipality of S o Paulo). The results showed that the participants recognized: (1) the sphere of social determinants at the base of adolescents' health problems and (2) in addition to disease processes, a set of social problems impacting the health-disease process, highlighting drug use and violence. Health needs are translated as demands for cross-sector public social policies.     

Health professionals and legal abortion in Brazil: challenges, conflicts, and meanings

This article discusses the roles of social workers, psychologists, nurses, and physicians concerning abortion and their participation in assisting legal abortion in Brazil for women victims of sexual violence. The working hypothesis was that many health professionals might oppose such programs on the grounds that they involve interruption of pregnancy. This qualitative study interviewed 12 health professionals and two program managers in the State of Paraíba and the Federal District (Brasilia). The health professionals' representations of abortion ranged from a moralist and religious concept to the promotion of women's rights and autonomy. The health professionals faced obvious challenges in dealing with the abortion issue. Their experience in treating women had fostered changes in values and a reinterpretation of the meaning of their own practice.     

Prevalence of near vision deficiency and related factors: a population-based study

The objective of this article was to estimate the prevalence of presbyopia in adults > or = 30 years and explore associated characteristics such as demographic, socioeconomic, and individual variables. A cross-sectional, population-based study was performed with 3,007 adults > or = 30 years in Pelotas, Rio Grande do Sul, Brazil. Near vision acuity was evaluated using the Jaeger table, and other variables were investigated using standardized, pre-coded questionnaires. Prevalence of presbyopia was 54.7%. When visual acuity was measured using visual corrective means, prevalence was 29.34%. Age and female gender were associated with the outcome variable after controlling for confounding. Some 42.4% of the sample reported not requiring near vision for routine daily tasks. The conclusion was that presbyopia displays a high prevalence in the adult population and is directly related to increasing age, especially 45 years of age and appearing earlier in women. In some 30% of individuals who already use visual corrective means, the latter are ineffective for near vision.     

Risk factors for infection with Giardia duodenalis in pre-school children in the city of Salvador, Brazil

A cross-sectional study of 694 children aged 2 to 45 months selected from 30 clusters throughout the city of Salvador, Bahia (pop. 2.3 million) was carried out as part of a longitudinal study of diarrhoea in order to identify risk factors for infection with Giardia duodenalis. Variables studied included three social and demographic factors (such as mother's education and marital status), five relating to the peri-domestic environment (rubbish disposal, open sewers, paving of the street), seven relating to the home itself (house construction, susceptibility to flooding, water supply and sanitation) as well as a score for hygiene behaviour based on structured observation. After multivariate analysis using a hierarchical model, only four significant risk factors were found: (a) number of children in the household under five years (b) rubbish not collected from the house (c) presence of visible sewage nearby, and (d) absence of a toilet. All four were significant at the 1% level.     

Adrenal incidentalomas: indications for surgery

Adrenalectomy represents the gold standard treatment for hyperfunctioning adrenal incidentaloma. In cases of silent adrenal masses, on the other hand, the surgical removal of an adrenocortical cancer entails the sacrifice of a large number of safe benign masses, and in most cases surgery is therefore unjustified. The aim of this paper was to clarify the surgical indications for adrenal incidentaloma by reviewing our experience in comparison with the main reference literature. Over the period from 1995 to 2001 we managed 40 cases of incidentaloma. US and CT abdominal scans, adrenal scintigraphy and biochemical tests were performed on an outpatient basis. Seven pre-Cushing syndromes were removed. Ten incidentalomas measured 4 cm or more in diameter: 5 of these were operated on and in 5 cases surgery was not feasible or was refused. Only one malignant mass was detected (an angiosarcoma). Four postoperative minimal complications (18.7%) were observed. The follow-up (median: 48 months) was uneventful. The surgical approach was traditional in 11 cases and laparoscopic in 1 case. Surgery should be considered mandatory in cases of hyperfunctioning adrenal masses in the presence of suspect radiological evidence, in cases of discordant CT and scintigraphy findings and when the maximum diameter is 4 cm or more.