BackgroundConsidering the inequalities and the areas of low socioeconomic status in Brazil, access to health services is a challenge and the delay between diagnosis and treatment represents an important factor of worse prognosis in patients with breast cancer. Herein, we describe the clinical and epidemiological profiles of women with breast cancer and evaluate their access to health services, as well as treatment delays, at a reference centre of the Cariri region, Ceará, Brazil.MethodsThis is a retrospective study that included 473 women treated with breast cancer between 2009 and 2011 at the Oncology Centre of the Cariri.ResultsThe majority of these patients were aged between 40 and 69 years old (65.7%), without a completed high school degree (89.2%). They were married (62.9%) and were already diagnosed but had not yet been subjected to any previous treatment (77.8%). It was observed that 91.8% were referred from the public health service, and treatment was paid for by the public health service in 92.9% of the cases. The patients whose source of referral was the public system waited longer between diagnosis and the treatment initiation (p = 0.031; Mann–Whitney’s test), with a median waiting time of 71.5 days versus 39 days for those receiving referrals from private services. In addition, those with public referrals prior to diagnosis also experienced a longer waiting time between the first medical visit and treatment initiation (77 days vs. 37 days; p = 0.036; Mann–Whitney’s test), with the waiting time for the biopsy being an important factor in this delay.ConclusionsLate diagnosis was often the result of inefficiency of the prevention policies coupled with difficulty accessing the public health network. It was commonly observed that, even after diagnosis, the patients needed to wait too long before entering the Oncology Service because of long waiting queues in the public health system.

http: //dx.doi.org/10.17058/reci.v6i2.6427 Justificativa e Objetivos: A depressão é um problema de saúde pública que atinge cerca de 154 milhões de pessoas mundialmente, tendo sua incidência crescente nos últimos anos. Frente a esta problemática destaca-se o idoso neste contexto com um percentual de 15% de prevalência para algum sintoma depressivo, o que requer uma atenção especial e ações de prevenção e cuidado para tal população. Sendo assim, objetivou-se compreender acerca de depressão na terceira idade, o perfil e o processo de prevenção e tratamento dos sinais e sintomas, na literatura nacional e internacional. Método: Trata-se de uma revisão sistemática da literatura realizada nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Medical Literature Analysis and Retrievial System Online (MEDLINE) e Scientific Electronic Library Online (SCIELO). Foram considerados os estudos do tipo artigos, dissertações e teses em português, inglês ou espanhol, entre os anos de 2010 a 2015, utilizando os descritores: depressão, idoso e geriatria. Para a coleta de dados utilizou-se o instrumento de Ursi, que inclui a avaliação do título do estudo, principais resultados e conclusões. Resultados:Após busca nas bases de dados, encontraram-se 261 estudos, sendo que após aplicação dos critérios de inclusão, selecionou-se 44, ao implementar o instrumento supracitado, finalizou-se com 17. Os resultados evidenciaram o perfil dos idosos acometidos pela depressão, formas de tratamentos, chegada ao serviço de saúde e comorbidades associadas. A pesquisa também mostrou a importância do estímulo ao autocuidado, ativação e engajamento deste público e familiares em atividades educativas, treinamento profissional de saú-de e ampliação do sistema como fatores importantes ao cuidado destes usuários. Conclusão: Os profissionais de saúde que lidam com o público idoso devem estar atentos aos sinais e sintomas da depressão, além de estarem constantemente capacitando-se para atender as demandas por meio de uma assistência eficaz e de qualidade, estimulando também métodos não farmacológicos de alívio dos sintomas, além de identificar o perfil destes idosos os quais as comorbidades associadas a depressão são mais comuns. Background and Objectives:Depression is a public health problem that affects approximately 154 million people worldwide and its incidence has increased in recent years. Regarding this problem, elderly individuals show a percentage of 15% prevalence for some depressive symptoms, which requires special attention and prevention and care actions for this population. Thus, this study aimed to understand about depression in the elderly, the profile and the process of prevention and treatment of signs and symptoms in national and international literature. Method: This is a systematic review of the literature carried out in the following databases:Latin American and Caribbean Health Sciences (LILACS); Medical Literature Analysis and Retrieval System Onli- RESUMO ABSTRACTRecebido em:

The physiological basis of neurofunctional reorganization in stimulating the nervous system is justified and ratified by the concepts of neuroplasticity and therefore, its use in neonatology is well indicated. Objective: Describe how Neurofunctional reorganization throughPadovan method can contribute to restore neurologic function of newborns and can avoid the need for gastrostomy and shortening hospital stay.Method: Descriptive and retrospective study performed in a hospital at Ceará´s inland, Brazil, through analysis of medical records. 92 patients from the neonatal ICU who suffered perinatal asphyxia and evolved with neurological disorders were evaluated. Patients received Neurofunctional Reorganization therapy, which is the performance of physical and oral exercises that complement each other in order to recover lost functions and also prepare the body to acquire functions and capabilities which it has potential for.Results: Eighty-two patients completed the therapy and showed positive results (89.1%). The main expected outcome was the recovery of suction and this was achieved in between 8 and 150 days. 48 cases showed an improvement between 8 and 30 days of treatment (56%). Conclusions:The Neurofunctional reorganization proposed by Padovan is effective in the recovery of neurological function of newborns, especially the suction, shortening the hospital stay and avoiding gastrostomy.

Introduction. Inguinal hernia is a common disorder with an estimated prevalence of 1.2% of the entire population and it is 12 times more common in males. Objective. To describe a case of appendix with signs of inflammation in the hernia sac, condition that is rare and difficult to diagnose, and to perform literature review, describing the most relevant aspects and the main controversies. Method. Report of a case and search in PubMed on June 1, 2015, using the terms “Appendix” [MeSH term] AND “hernia, inguinal” [MeSH term]. Results. The search resulted in 38 articles in total, and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Discussion. The search resulted in a total of 38 articles and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Conclusion. Amyand's hernia is a rare and difficult to diagnose condition, being commonly found occasionally in surgical procedures. It should be remembered in the presence of cases of incarcerated hernia, due to its possible complications if not diagnosed.