Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

O acolhimento como promoção da saúde entre pacientes com câncer

Cancer has been affecting people all around the world; disregard sex, ethnicity or social class. Despite the fact it is not always deadly, to be diagnosed and treated of cancer brings a lot of physical, emotional and social suffering, specially for those with less economic resources. Considering the complexity of the problem, there has been perceived that medical treatment is not enough to support cancer patients. There is an increasing understanding about their necessity of integral care, supposed to be given by a multidisciplinary health care equip that can consider all the different aspects involved in the illness process. Everyone has a particular way of been ill or healthy, and gives different meanings to the experienced events. The starting point of the research was the contact with a called work `group of shelter', developed with cancer patients by a multidisciplinary health care equip working on the LIGA Norte Riograndense Contra o Câncer. The research goal is to identify meanings people give to the shelter they receive in the group and to understand the way they experience the disease. Considering it singularity of this process, one worked with individually half-structuralized interviews, carried through with nine patients of the chemotherapy clinics and suck, that they had passed for the experience of the group of shelter, having approached getting ill, the treatment, the shelter and the recreation of the psychosocial processes (or not) after all this process. It was chosen as focus of analysis the creation of psychosocial processes and production of felt of these social actors through its discourse analysis perspective, boarded in accordance with the following thematic axles: the experience of the cancer, the shelter and recreation of the psychosocial processes the life. It was found that shelter has an extensive meaning going beyond the the group and involving others besides the multidisciplinary health care equip, and being important to give each patient the best possible benefit. It was also identified the importance of other social actors, such as relatives, friends and neighbors; added of religious faith, mentioned by all interviewees. It is to be considered the recovering capacity shown by eight interviewees, demonstrated by changing the way of interacting with others, getting new values and behaviors, and demonstrating more wisdom. We can consider the possibility of making this strategy to become part of the everyday practices of others health services working with cancer patients, what we think can help to minimize their suffering

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

Câncer de mama: vivência das usuárias dos serviços prestados pela Liga Norte Riograndense Contra o Câncer

This study is about the users' experiences of the services offered by League Against Câncer that are in treatment of breast cancer, focusing on how the health/illness process develops. It is distinguished, in this context, the National Politics of Health, approaching the sprouting, implantation and consolidation process of the Unified Health System and its shocks on the installment of health services to the low-income population as a legit right from Citizen Constitution. It has as an objective to analyze how the social-economic extract of these women intervenes with such process, the aspects who involve the cancer while a pathology, approaching the signals, symptoms, forms of prevention, diagnosis, among other aspects that configure themselves as important points to the understanding of these experiences, since the diagnosis, treatment and control phases. The research was carried out with 25 women, between the months of January and February of year of 2005. The used technique was the scriptstructured interview, whose universe was defined through intentional sample. The following distinguishes as a result of the research: The majority of the women has its origins on the interior of the state, possesses a familiar income from one to three minimum wages and didn't make any kind of prevention before diagnosis, currently make treatment, beyond other aspects. It becomes necessary posterior studies on this social problematic, with respect to the personal, professional, familiar and social daily behavior of these women. It is worth mentioning that the role of the social assistant in the developed work with these women, understanding all the impediments associated with such experiences, as well as giving information about the rights of the patients with cancer, conquered through the years

Análise da imunoexpressão de OCT4 e CD44 em neoplasias de glândulas salivares menores e maiores

Salivary gland neoplasms exhibit a wide variety of biological behavior and a high morphological diversity raises the interest in researching these lesions. The stem cells are the main source for the generation and maintenance of cell diversity, disorders in the regulation of these cells can lead to the production of altered stem cells, termed cancer stem cells capable of generate the tumor. Researches on cancer stem cells and associated proteins have been developed in some oral cancers; however, their role in salivary gland neoplasms is not well established. Thus, the aim of this study was to identify the tumor parenchyma cells exhibiting stem cell characteristics, by evaluating the immunoreactivity of OCT4 and CD44, in a number of cases of salivary gland neoplasms. The sample consisted of 20 pleomorphic adenomas, 20 mucoepidermoid carcinomas and 20 adenoid cystic carcinoma located in minor and major salivary glands. The expression of OCT4 and CD44 was evaluated by the percentage of positive cells (PP) and the intensity of expression (IE), it is realized the sum of the scores, resulting in the total score immunostaining (PIT) ranging 0-7. All studied cases showed positive expression of OCT4 and CD44 and higher values than the control groups. It was observed that for OCT4 luminal cells and non-luminal were immunostained in the case of pleomorphic adenomas and adenoid cystic carcinoma. Already the immunoreactivity of CD44 was particularly evident in the non-luminal cells of these lesions. In mucoepidermoid carcinomas for both markers, there was immunoreactivity in squamous and intermediate cells and absence of staining mucous cells. For both markers, a statistically significant higher immunostaining was verified in neoplasms located in the major salivary glands compared with lesions in the minor salivary (p<0.001). At the total sample and in the group of minor salivary glands, malignant neoplasms exhibited higher immunoreactivity for OCT4 than pleomorphic adenoma. However, there was no statistically significant difference between the lesions and between their classifications histomorphologic. Analyzing the correlation between OCT4 and CD44 immunoexpressions, a statistically significant moderate positive correlation (r = 0.444) was observed. The high expression of OCT4 and CD44 may indicate that these proteins play an important role in identifying cancer stem cells, allowing a prediction of biological behavior of salivary gland neoplasms.

Simulador radiográfico antropomórfico de mama humana

Mammography is a diagnostic imaging method in which interpretation depends on knowledge of radiological aspects as well as the clinical exam and pathophysiology of breast diseases. In this work a mammography phantom was developed to be used for training in the operation of mammographic x-ray equipment, image quality evaluation, self-examination and clinical examination of palpation. Polyurethane was used for the production of the phantoms for its physical and chemical properties and because it is one of the components normally used in prostheses. According to the range of flexibility of the polyurethane, it was possible to simulate breasts with higher or lower amount of adipose tissue. Pathologies such as areolar necrosis and tissue rejection due to surgery reconstruction after partial mastectomy were also simulated. Calcifications and nodules were simulated using the following materials: polyethylene, poly (methyl methacrylate), polyamide, polyurethane and poly (dimethyl silicone). Among these, polyethylene was able to simulate characteristics of calcification as well as breast nodules. The results from mammographic techniques used in this paper for the evaluation of the phantoms are in agreement with data found in the literature. The image analyses of four phantoms indicated significant similarities with the human skin texture and the female breast parenchyma. It was possible to detect in the radiographic images produced regions of high and low radiographic optical density, which are characteristic of breasts with regions of different amount of adipose tissue. The stiffnesses of breast phantoms were adjusted according to the formulation of the polyurethane which enabled the production of phantoms with distinct radiographic features and texture similar to human female breast parenchyma. Clinical palpation exam of the phantoms developed in this work indicated characteristics similar to human breast in skin texture, areolar region and parenchyma