Significant attention to palliative care in terminally ill patients has only been effective in Brazil since the year 2000, although there have been isolated actions since the 1980s. When the case involves fetuses or neonates unable to cure, communication and care with the family members only received attention and effective organization starting in 2017. Notably in the years 2015 and 2016 there was an epidemic of microcephaly and along with the persistent crisis of drug users has raised the indices of malformations to a level higher than 3 % of the world average. Here we aim the evaluation of: a) social, educational and spiritual profile of the mothers; b) structure of the specific teams related to palliative care in neonatology; c) recommendations and protocols currently used in the country. The method used is an electronic retrospective on databases and government data; evaluation of the location and composition of palliative care teams in the country. The data found clearly point out that for Brazilian women, the characteristics of regionality in the country, educational level, religiousness and quality of life directly influence pregnancy and the acceptance or not of the possibility of death, directly influencing perinatal palliative care, which, by the way, is still developing methodologies for this type of action.

Cervical cancer (CC) is one of the most common cancers among women worldwide. The relation of the human papillomavirus (HPV) with CC and its precursor lesions was first suspected for over 40 years. The indoleamine 2,3 dioxygenase (IDO) is an immune modulator enzyme responsible for the immune system tissue protection mechanism, which may be the key to the tumoural persistence. HPV oncoprotein E7 promotes the increase in cyclin-dependent kinase inhibitor p16 (CDKN2A/p16). The isolated and combined analysis of CDKN2A/p16 mRNA to CC diagnosis was done with promising results. The aim of this study is to evaluate the correlation between IDO mRNA and CDKN2A/p16 mRNA. We will explore the potential of both as diagnostic tools. RNA was extracted from tissue samples. cDNA was generated with High Capacity RNA-to-cDNA kit. The real-time PCR results were analysed using nonlinear curve estimation, ROC curve, Chi-squared test, the proportion of variance explained and Galen and Gambino formulas. From 270 patients attended, colposcopy examination was performed in 110 and the biopsy in 75 patients. We found a positive correlation in patients older than 28 years old with low-risk lesions, but the correlation is lost in high-risk lesions. Although cytology, IDO mRNA and CDKN2A/p16 mRNA could not differentiate the risk groups, IDO combined with CDKN2A/p16 mRNA results could (p = 0.028). The best diagnostic result was achieved by IDO coupled with CDKN2A/p16 mRNA, which may considerably increase the sensitivity of screening for CC.

Introdução: Diabetes mellitus é uma epidemia mundial. Considerado um dos principais problemas de saúde pública do país, conhecer como vivem os diabéticos é de grande importância para a introdução de diretrizes que possam contribuir para um controle glicêmico adequado, melhorando a qualidade de vida desses indivíduos. Objetivos: Avaliar a qualidade de vida de pacientes com diabetes mellitus tipo 1 (DM1) tratados com insulina convencional NPH e Regular. Metodologia: Trata-se de um estudo observacional, retrospectivo e transversal. Foram entrevistados 44 pacientes com DM1 que faziam uso de insulina convencional. A qualidade de vida foi avaliada por meio do instrumento DQOL-

The Brazilian healthcare structure has evolved in recent decades, but there are still shortages of beds in Intensive Care Units, especially in Neonatal Units. In early December 2019 they reported the first cases of a new infectious coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present work makes an observational assessment of the number of deaths in the year 2020 related to the New Coronavirus Pandemic, the number of births and the panorama of Neonatal Intensive Care Unit (NICU) in the last decade. The results showed an increase in the number of deaths, with a predilection for elderly men; reduction in the number of births evaluated by the civil registry and an increase in NICUs in the last decade. This ratio was 2.6 beds per thousand births in 2010, rising to 2.9 per thousand in 2019 and reaching 3.4 beds per thousand births in 2020. Thus, the forced increase in the number of beds in the therapy unit The intensive care unit approached the proportion recommended by the Brazilian Society of Pediatrics, which is 4 beds for every thousand births.