Identificação de crianças e adolescentes com suspeita de câncer: uma proposta de intervenção

Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte

Processo de cuidar de crianças hospitalizadas com câncer

The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs

Tecendo vivências e sentidos do câncer infantil : família, doença e redes de apoio social em Natal-RN

This paper discusses the experiences related to the treatment of children´s cancer which had children, their mothers and families as their main characters. They were mainly originated from areas in the countryside and urban poor areas in the State of Rio Grande do Norte. The non-governmental organization Grupo de Apoio à Criança com Câncer (GACC) was the privileged ethnographic location. In this setting, the mother, which was called acompanhante (companion), and the children, defined as pacientes (patients), were often sheltered in reason of therapeutic practices and the treatment undertaken by children in a nearby hospital. This study aims to focus on the therapeutic itinerary, beyond the children´s suffering, dealing with the family as a whole, since the moral values from these popular families imply the complete involvement of the family in relation to the illness and its treatment. Therefore, it is experienced as a family problem. We also intend to understand the construction of meanings to the illness, dealing with the ideological continuity in the relationships between the families and the GACC. These meanings were built in the intersection of these two spheres, which refer particularly to medical, religious and emotional explanations. Ethnographic methods were applied in this research at the entity and another social contexts, such as the family households. I also tried to retrieve the process of treatment outside the GACC, visiting the family context, when doing dense interviews or just having conversations with informants. It was found that the GACC, as a non-governmental organization, generates a negotiation of identities, which develops, then, through the family as a whole, but also through the child and especially the mother, affecting, in some way, their internal organization. Furthermore, the meanings of the experience of illness appeared to be shaped by the family sphere as well as by the logic of public health structures

Avaliação clínica da saúde bucal de crianças com neoplasias malignas atendidas no Hospital Infantil Varela Santiago em Natal-RN

The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

Ser-no-mundo com a criança portadora de câncer compreendendo a experiência de psicólogos nos serviços de oncologia pediátrica de Natal-RN

Cancer goes on to be a frightening disease by humanity, simetimes,it is considered as death, suffering and stigma synonym. Occurring at childhood, this meaning seems to acquire a more intense conotation, having in view of the perplexity and godliness feeling in the presence of the precocity of events, nearly always associated to the death. A psychologist co-existence with the cancer children is going acquiring, thus, a permeated sense by incognitas , fears and fantasy, which raised us the following question: how does the psychologist that answers children with cancer lives this experience? Therefore, the aim this research was to understand this co-existence experience. Our theoretical perspective comes from an existencial fenomenology and, more specifically, the Humanistic Approach and Martin Heidegger Existencial Ontology. The metodology is qualitative of phenomenological character. The access instrument to the experience was the narrative, such as purpose by Walter Benjamin. They were carried out nine semi-open interviews with psychologists who work on pediatric oncology services of Natal-RN city. Such interviews were recorded in cassette, transcripted and later, re-educated. These interviews were recorded, transcribed and later on edited with the help of the interviewee and turned into a text. The narrative comprehension was carried out on Heidegger Existencial Ontology, on dada exaustive reading and the clipping of indicative passages of experience sense of being psychologist on this area. The research suggests that the experience is oriented of clinic kowing-doing, being crossed by implications of key thematics which indicate the care as central ontologic element that orientates the way as these professionals come being in the world in association with the clientèle. Besides, the caring experience of these children acquire the sense of true living experience, since the cancer undoes the immortality illusion, launching the psychologist to his/her condition of being to the death and with that, calling him/her the authenticity. Is is only not dealt with to experience the anguish and the death imminence, but above all, re-meaning them in favour of a continual learning, of quality answering , besides other possibilities. Working with child cancer brings news perspectives and world views, making the psychologist a more human people and sensitive to the distracted needs. And we believe that, regardless of area which actuates, being psychologist is a particular way which choose to be citizen. Is is a project that will be delimited by society, history and culture and after all, by us like human being. Therefore, we understand that the results this research suggest the discussed thematic deepening on this intervention field in order to new sense possibilities can arise giving origin to other reflections about the clinical practice, the professional formation in Psychology and other possible developments

Percepção de estigma e qualidade de vida em crianças com neoplasia

The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment

Tecendo vivências e sentidos do câncer infantil : família, doença e redes de apoio social em Natal-RN

This paper discusses the experiences related to the treatment of children´s cancer which had children, their mothers and families as their main characters. They were mainly originated from areas in the countryside and urban poor areas in the State of Rio Grande do Norte. The non-governmental organization Grupo de Apoio à Criança com Câncer (GACC) was the privileged ethnographic location. In this setting, the mother, which was called acompanhante (companion), and the children, defined as pacientes (patients), were often sheltered in reason of therapeutic practices and the treatment undertaken by children in a nearby hospital. This study aims to focus on the therapeutic itinerary, beyond the children´s suffering, dealing with the family as a whole, since the moral values from these popular families imply the complete involvement of the family in relation to the illness and its treatment. Therefore, it is experienced as a family problem. We also intend to understand the construction of meanings to the illness, dealing with the ideological continuity in the relationships between the families and the GACC. These meanings were built in the intersection of these two spheres, which refer particularly to medical, religious and emotional explanations. Ethnographic methods were applied in this research at the entity and another social contexts, such as the family households. I also tried to retrieve the process of treatment outside the GACC, visiting the family context, when doing dense interviews or just having conversations with informants. It was found that the GACC, as a non-governmental organization, generates a negotiation of identities, which develops, then, through the family as a whole, but also through the child and especially the mother, affecting, in some way, their internal organization. Furthermore, the meanings of the experience of illness appeared to be shaped by the family sphere as well as by the logic of public health structures

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

BORGES,D. M. L.et al. Mortalidade por câncer de boca e condição sócio-econômica no Brasil.Cad. Saúde Pública, Rio de Janeiro, v.25,n.2, p.321-327, fev, 2009

A utilização de serviços odontológicos entre crianças e fatores associados em Sobral, Ceará, Brasil

NORO, L. R. A. et al. A utilização de serviços odontológicos entre crianças e fatores associados em Sobral, Ceará, Brasil. Cad. Saúde Pública, v. 24, n. 7, p. 1509-1516. 2008. ISSN 0102-311X.

Achados fundoscópicos em crianças portadoras de anemia falciforme no estado do Rio Grande do Norte

Detectar os principais achados fundoscópicos em crianças portadoras de hemoglobinopatias falciformes. Métodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Serviço de Oftalmologia do Hospital Universitário Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pré-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade média foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqüente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqüência da retinopatia por células falciformes foi maior após os 10 anos de idade, sendo mais freqüente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e “black sunburst” (7/26). Conclusões: Observamos que a incidência de retinopatia por células falciformes aumentou após os 10 anos de idade e não evidenciamos achados da doença proliferativa. Portanto, enfatizamos a necessidade do exame oftalmológico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicações oculares

Atuação das equipes da atenção primária na identificação precoce do câncer infanto-juvenil

Identificar o conhecimento de profissionais da atenção primária sobre a identificação precoce do câncer infanto-juvenil e descrever o desempenho das equipes de saúde antes da realização de treinamentos para identificação precoce do câncer infanto-juvenil. Método: Os dados foram obtidos por um questionário e grupo focal com 30 profissionais de uma Unidade de Saúde da Família, e analisados por temas geradores. Resultados: Os profissionais possuem conhecimentos sobre a identificação do câncer infanto-juvenil, e, demandam conhecer mais sobre os sinais e sintomas para identificação precoce, e a prestação de uma assistência sistematizada. Conclusão: Torna-se fundamental estimular a qualificação dos profissionais da atenção primária para a identificação precoce e o fortalecimento de uma rede de assistência que proporcione atendimento integral e a redução no retardo do diagnóstico de câncer infanto-juvenil

O que tenho a ver com isso? aula-vivência sobre violência contra crianças e adolescentes

A violência constitui hoje a principal causa de morte em crianças de 5 a 19 anos, o que tem imposto aos profissionais de saúde um olhar mais atento a estas questões, bem como uma formação que busque compreender este fenômeno sobre os vários prismas que a circunscreve. O objetivo deste artigo é relatar a experiência vivenciada com alunos do curso de Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte numa aula-vivência sobre esta temática. A aula foi baseada numa prática pedagógica de ação reflexiva. Desenvolveu-se a partir da integração dos conteúdos teóricos e práticos, articulando-os com temas sociais, políticos e econômicos. A aula foi dividida em três momentos: um momento de sensibilização; um segundo momento onde foi apresentado e discutido o arcabouço teórico, científico e legal que envolve o tema; e um terceiro, que visou estimular uma reflexão sobre a realidade vivenciada nos serviços de saúde por profissionais que atuam diante de situações de violência. Nos três momentos da aula pudemos proporcionar ao aluno a inquietação e a reflexão necessárias para pensarmos sobre a violência em toda a sua complexidade, pluricausalidade e com toda a carga de preconceito em que esta se encontra envolvida

Crianças com infecções respiratórias agudas: como são cuidadas em casa?

Objetivou-se, neste estudo exploratório/descritivo, identificar conhecimentos e necessidades dos cuidadores da criança com Infecção Respiratória Aguda (IRA) através de uma amostra de 129 crianças atendidas no serviço de crescimento e desenvolvimento de uma unidade de saúde. Foram aplicados formulários junto aos cuidadores, em seu domicílio, nos meses de fevereiro e março de 2002. Os cuidadores eram do sexo feminino, a maioria jovem, com ensino fundamental incompleto e com renda de 1 a 2 salários. Em relação aos primeiros cuidados com a criança doente, 48,2% dos cuidadores procuram o médico, 36,6% medicam por conta própria e 13,2% utilizam fitoterápicos. Como medidas de prevenção contra pneumonia em crianças com IRA leve, os cuidadores utilizam medidas de senso comum e sabem reconhecer sinais de gravidade das doenças, por experiências anteriores, revelando uma lacuna do conhecimento dos principais sinais e sintomas de doenças graves do trato respiratório

Avaliação das pressões respiratórias máximas em crianças e adolescentes da grande Natal: elaboração de uma equação preditiva

The human respiratory system was so designed that would allow efficient ventilation, regardless of variations in the external environment that may hinder the act of breathing, such an act involves dozens of variables, among them we find the respiratory depression, which is nothing more than respiratory muscle strength. The pressures are widely used in several cases: Neuro-muscular; evolution of pulmonary dysfunction and a predictor for discontinuation of mechanical ventilation. Therefore it was proposed to carry out evaluations of these respiratory pressures for children and adolescents aged 10 to 16 years and propose a predictive equation that involves the anthropometric variables age (A, years), body mass (BM, kilograms) and height (H, meters) with maximal respiratory pressures (maximum inspiratory and expiratory pressure). Evaluations were performed in this age group of students in public and private schools of the Grande Natal , measurements were performed using the analogue manometer, were children and adolescents and their parents gave informed consent. 517 samples were taken, and 250 for males (M), 255 for females (F) and 12 were excluded according to our exclusion criteria. The sample was subdivided into three age groups (10-11, 12-13 and 14 to 16 years old). It was found through the student s t test (p ≤ 0.05) for all variables studied, children and male adolescents had higher means than females, except for the MC. For the correlation between the variables found significant correlation (p <0.05) among all the variables when analyzed as pairs except between MIP and height for females. The development of predictive equations (for p ≤ 0.05) based on three types of strategies adopted were restricted to two association between anthropometric variables isolated, resulting in: for males: MIP = -32.29 + (-2.11*A) + (-0.52*BM), MIP = 9.99 + (-0.36*BM) + (-49.40*H); MEP = 18.54 + 3.53*A + 0, 42*BM, MEP = -33.37 + 2.78*A + 52.18* H, MEP = -17.39 + 0.33*BM + 55.04*H; and, for females we find: MEP = 24.32 + 2.59 * A + 0.24*BM

Prevalência da infecção por Chlamydia Trachomatis em mulheres atendidas no Programa de rastreamento do câncer de colo do útero

Genital infection with Chlamydia trachomatis is now recognized as one of the most prevalent sexually transmitted infections (STDs). Despite major advances in laboratory diagnosis techniques, primarily the character of asymptomatic chlamydial infection in both men and in women constitutes the basis for the formation of reservoirs that perpetuate transmission and acquisition of this and other STDs. The asymptomatic in women favors the rise of infection to the upper genital tract, causing injuries that can result in infertility. An examination of population screening for early detection and treatment of asymptomatic infections is the key step in combating this major public health problem. The present study aimed to evaluate the prevalence of infection by C. trachomatis in sexually active women attended the screening program for cervical cancer of the uterus in health facilities in municipalities in different regions of the State of Rio Grande do Norte, and identify factors that may contribute to the spread of this pathogen and its relationship with the lesions of the uterine cervix. It is a cross-sectional study aimed at detecting the presence of genital tract infection by C. trachomatis either in isolated form or in association with human papilloma virus (HPV) infection in asymptomatic women. Were included in this study, a total sample of 1,134 women aged 13-76, mean 34.4 years, from March 2008 to September 2012. Specimens containing exfoliated cells of the epithelium of the uterine cervix were analyzed by examining Pap cytology for the detection of possible injuries, and the polymerase chain reaction (PCR) for detection of plasmid DNA from C. trachomatis and HPV. Infection with C. trachomatis was detected with overall prevalence rate of 8.1% in the isolated form and 2.8% in co-infection with HPV. The infection was detected in 7.4% of women with normal cytology 11.5% of those with atypical cells of undetermined significance (ASC-US) and 16.7% of those with low-grade squamous intraepithelial lesion (LSIL). We observed an association between C. trachomatis and incidence of low-grade squamous intraepithelial lesion (LSIL). The genital tract infection by C. trachomatis alone was associated with education level, ethnicity and parity, revealing that women with higher education, those of non-white ethnicity and those who had three or more pregnancies were more likely to acquire infection. Levels very close to statistical significance were observed for chronological age, age at first sexual intercourse and first pregnancy. There was no association with marital status, number of sexual partners. Co-infection with C. trachomatis and HPV was detected in 2.3% of women with normal cytology, who had 5.1% in ASC-US and 10.4% in those with LSIL. No association was found between infection C. trachomatis and increased risk of HPV infection, but women with simultaneous infection by both pathogens showed greater risk for LSIL. Co-infection was more prevalent among single women, who had in the first sexual intercourse under 18 years and those who had two or more sexual partners over a lifetime