Objectives: To investigate whether the interval between diagnosis and initiation of treatment above 60 days in women who underwent outpatient treatment between 2000 and 2015 by the SUS in Minas Gerais, Brazil, is associated with the patients' macroregions of residence. Methods: Non-concurrent longitudinal study of a cohort of 8872 women from Minas Gerais who underwent outpatient cancer treatment (chemotherapy or radiotherapy) under expenses of SUS in the same state, from 2000 to 2015. The response variable was the interval between diagnosis and initiation of treatment of women with cervical cancer (up to 60 days or more than 60 days) and the explanatory variable was the patients' macroregion of residence (13 macroregions of residence). The covariates were age, cancer stage at diagnosis, first treatment received, number of comorbidities, and distance between municipality of residence and treatment. Logistic regression was used to assess associations. Results: The average number of days to start treatment was 50.7 days, and most started within 60 days (61.9%). About 83% of women had their treatment in the same macroregion of residence; however, only 40% of women had their treatment in the municipality where they live. It was found after all adjustments that living in any of the 12 non-A health macroregions increases the chance to start treatment after 60 days from diagnosis. The highest magnitude of association were found in the F macroregion, with OR equal to 4.27 (95% CI; 3.32-5.50). Conclusions: There is a disparity in the timely treatment of women among health macroregions of the state of Minas Gerais. Investigations of the possible inequalities and barriers in the itinerary of women with cervical cancer that influence timely treatment are needed.

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It is still on discussion how oral anticoagulant therapy must be interrupted. A progressive diminution of drug intake have been proposed in order to avoid a MreboundM of vitamin K-dependent procoagulant factors. At the present, it is well known that coumarin drugs affect not only the biologic activity of factors II, VII, IX and X but also Protein C (PC), an inhibitor of coagulation kinetics, and their cofactor Protein S. With the aim to determine the recovery level of PC in relation with the others vitamin K-dependent factors, the effect of suppression of anticoagulant therapy in patients under chronic treatment with acenocoumarin was studied.Quick time, functional factors II, VII, X (one stage methods), functional PC (Francis method) and immunological Factor II and Protein C (Laurell) were determined before and 36 hours after suspension of acenocoumarin administration.Results showed that: 1) Recovery levels of functional Protein C (increased from 28.55% ±2.57 to 72.64% ±5.9) were significantly higer than functional Factor II (22.09% ±2.34 to 30.73% ±8.64), Factor VII (22.55% ±2.01 to 40.73% ±4.85) and Factor X (23.27% ±2.66 to 39.18% ±3.19). Statistical analysis (Newmann-Keuls test) showed at least a p<0.01 between PC increase and factors II, VII or X increment.2) No significant differences were seen between immunological levels of Factor II before and after suspension of acenocoumarin.3) Levels of immunological PC in patients under anticoagulant therapy were higer than functional PC. After acenocoumarin suppression, not correlation was seen between immunological and functional Protein C recovery.It is concluded that acute suppression of acenocoumarin does not induce a thrombotic tendency because the recuperation of functional Protein C is more important than factors II, VII and X recovery.

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La enfermedad cerebrovascular isquémica es una de las principales causas de mortalidad a nivel mundial y se define como la muerte del tejido cerebral ocasionada por la obstrucción arterial que limita el aporte sanguíneo. El presente trabajo de investigación se realizó en el Hospital Teodoro Maldonado Carbo de la ciudad de Guayaquil, cuyo objetivo fue determinar la relación que existe entre la enfermedad cerebrovascular isquémica y la hipertensión arterial en los pacientes mayores de 40 años de enero del 2016 a diciembre del 2020. Metodología: Esta investigación es de tipo retrospectivo, correlacional, con enfoque cuantitativo, diseño de investigación no experimental y corte transversal. Tiene como universo a todos los pacientes mayores de 40 años con diagnóstico de enfermedad cerebrovascular isquémica e hipertensión arterial atendidos en el Hospital Teodoro Maldonado Carbo de enero del 2016 a diciembre del 2020 y que tenían sus historias clínicas completas, es decir, 476 pacientes; la muestra se convirtió en todos los pacientes del universo que cumplen con los criterios de inclusión y exclusión anteriormente mencionados. Resultados: Del total de la muestra el 63,2% corresponden al sexo masculino; el rango de edad predominante fue de 71 a 80 años con el 32,8%; y el 37,2% de los pacientes presentaron hipertensión arterial grado 1. Se determinó la asociación entre la enfermedad cerebrovascular isquémica y los grados de hipertensión arterial evidenciando una asociación significativa (P-VALOR=0,001<0,05).