Breast cancer is the most prevalent malignant neoplasm and the leading cause cancer of death among women globally. In Brazil, survival rates vary according to the region and few studies have been conducted on breast cancer survival in less developed areas, such as the Amazon region. The aim of this study was to analyze the five-year survival rate and prognostic factors in women treated for breast cancer in the city of Belém in northern Brazil. A retrospective hospital-based cohort study was conducted (2007–2013). Sociodemographic, clinical/tumor, and treatment variables were obtained from the records at the Ophir Loyola Hospital. Survival analysis involved the Kaplan-Meier statistical method and Cox regression analysis was performed. The significance level was 5% (p <0.05). A total of 1,430 cases were analyzed. Mean survival time was 51.71 (± 17.22) months, with an estimated overall survival of 79.4%. In the multivariate analysis, referral from the public health care system, advanced clinical stage, lymph node involvement and metastasis were associated with worse prognosis and lower survival rate. Radiotherapy and hormone therapy were associated with increased survival. These findings can contribute to the development of regional strategies for early detection of breast cancer, reducing the incidence and mortality rates and increasing survival time.
INTRODUÇÃO: A fisioterapia respiratória tem obtido um importante espaço e reconhecimento ao possibilitar resultados de grande eficácia no tratamento intensivo do recém-nascido (RN) e do lactente. Um dos importantes objetos de trabalho da fisioterapia na Unidade de Terapia Intensiva (UTI) neonatal e pediátrica são as técnicas de higiene brônquica rotineiramente utilizadas, as quais apresentam grande variabilidade. OBJETIVO: Verificar as evidências científicas a respeito dos possíveis efeitos benéficos ou adversos, indicações e contraindicações das técnicas de higiene brônquica mais utilizadas no RN e no lactente na UTI. MATERIAIS E MÉTODOS: Trata-se de uma revisão sistemática, utilizando ensaios clínicos, sem delimitação temporal, baseada no protocolo PRISMA. Foram utilizadas as seguintes bases de dados: PubMed, LILACS, SciELO, PEDro e ScienceDirect. RESULTADOS: Foram identificados um total de 154 artigos, apenas 10 atenderam aos critérios de inclusão. Destes 5 (50%) associam tapotagem/percussão torácica, drenagem postural, aspiração de vias aéreas superiores e/ou traqueal e vibração e/ou vibrocompressão torácica manual; 1 (10%) associa drenagem, vibração e percussão; 1 (10%) associa vibrocompressão e aspiração nasotraqueal; 1 (10%) associa percussão e vibração torácica; 1 (10%) estudo utiliza a aspiração traqueal e 1 (10%) utiliza a vibrocompressão torácica manual. CONCLUSÃO: A maioria dos estudos encontrados não relataram contraindicações relevantes para impedir o uso de técnicas de higiene brônquica na UTI neonatal e pediátrica, entretanto, alguns resultados foram controversos quanto a sua correta e eficaz indicação.
Introduction: Diabetes mellitus is accompanied by increased formation of reactive oxygen species (ROS) and decreased antioxidant capacity, leading to oxidative damage to cellular components. There is evidence to suggest that regular physical training positively changes oxidative homeostasis in the cells and tissues by lowering basal levels of oxidative damage, increasing resistance to oxidative stress. Objective: To verify the possible effects of aerobic physical training and resistance on glycemia and oxidative metabolism, and to determine whether there is any difference in outcomes resulting from different types of training in sedentary people with Type 2 Diabetes Mellitus (T2DM). Methods: A systematic review of controlled and randomized trials based on PRISMA. The databases LILACS, IBECS, Pubmed/MEDLINE, Cochrane Library, SciELO, PEDro, ScienceDirect and BIREME were searched, combining the descriptors type 2 diabetes mellitus, resistance training, aerobic exercise and oxidative stress in Portuguese, English and Spanish. The methodological quality of the papers was assessed by the PEDro scale. The data were read, analyzed, extracted and summarized. Results: Of the 1386 papers retrieved, only five met the inclusion criteria. The five selected papers, consisting of controlled and randomized clinical trials, were summarized. Conclusion: There have been many published studies reporting on exercises and diabetes. However, there is limitation when it comes to comparing their results. The variability of research methods and measurement instruments used makes it difficult to draw conclusions as to which physical training modality is most effective in reducing glycemic levels and oxidative stress in sedentary individuals with T2DM, considering that in each study analyzed in this review, the response to these variables is different. In future research, it would be important to standardize exercise modality, intensity, training time and evaluation parameters. Level of evidence I; Systematic review of RCTs (Randomized controlled trials).
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