SUMMARY INTRODUCTION: Acute appendicitis (AA) is the most common cause of surgical acute abdomen. Postoperative complications in emergency care are reflections of the surgical procedure and pre- and postoperative factors. OBJECTIVE: Define prognostic factors for patients who underwent appendectomy, comparing them with the literature. METHODS: Descriptive observational study with a cross-sectional design based on data from the emergency/urgency appendectomy records between September 2018 and April 2019. Variables of interest were considered based on intrinsic patient data, clinical status, and perioperative management factors. Primary outcomes considered: postoperative complications from hospital admission discharge and prolonged hospital stay for > 2 days. Secondary outcome: death. The results were evaluated by Fisher's exact test (p <0.05). RESULTS: We identified 48 patients undergoing an appendectomy. Young adults accounted for 68.7%. From the total, 58.3% were males, 6 (12.5%) had hospitalization> 2 days, 4 (8.3%) had complications and no deaths. Among the variables, the stage of AA, the time of complaint up until seeking care, and advanced age were correlated with worse prognosis during hospitalization (p <0.05). The emergence of immediate postoperative complications was correlated with longer hospital stay (p <0.05). DISCUSSION: The descriptive data of the sample converge with the epidemiological profile of patients with AA in the literature, corroborating the applicability of conventional guidelines. The results strengthen the hypothesis that the patient's flow with abdominal manifestations is complicated from the first contact with SUS to the resolution of the condition. CONCLUSION: Knowledge of the epidemiological profile and perioperative predictors that are most related to complications favor the appropriate management of patients.

SUMMARY OBJECTIVE To relate anxiety and depression levels to the spirituality levels of oncology patients in the ABC region. METHODS Cross-sectional study performed at the ABC University Center oncology outpatient clinics. For the evaluation of spirituality, the Religiosity, Spirituality, and Personal Beliefs instrument of the World Health Organization (SRPB-WHO) was applied. To evaluate the levels of depression and anxiety, the Hospital Anxiety and Depression Scale (HADS) was applied. Qualitative variables were described by frequency and percentage, and quantitative variables by mean and standard deviation or median and range. Relationships were established using either the T-test or Wilcoxon-Mann-Whitney test and correlations with Pearson or Spearman tests, depending on the normality assessed by the Shapiro-Wilk test. RESULTS We included 99 patients, 68% female, with a median age of 60 years (19 to 81). A total of 24% had high or borderline levels of anxiety and 21% of depression. There was a negative correlation between levels of depression and spirituality (rho = -0.44, p <0.001), and anxiety and spirituality (rho=-0.232, p=0.02). We found no significant difference between levels of anxiety, depression, or spirituality when stratified by schooling, income, ethnicity, or marital status. There was a positive correlation between levels of anxiety and depression (cor = 0.477, p <0.001). CONCLUSION Spirituality can be a complementary tool in the treatment of patients with cancer.

Introduction Patients submitted to arterial vascular surgeries are at a high risk of postoperative cardiac and non-cardiac complications, therefore developing strategies to lower perioperative complications is essential to optimize outcomes for this subgroup. Recent studies have suggested that the period of the day in which surgeries are performed may influence postoperative major cardiovascular complications but there is still no evidence of this association in vascular surgeries. Purpose Our goal is to evaluate whether the period of the day in which surgeries are performed may influence mortality and cardiovascular outcomes in patients undergoing non-cardiac vascular procedures. Methods Patients who underwent non-cardiac vascular surgeries between 2012 and 2018 were prospectively included at our cohort. For this analysis, subjects were categorized into two groups: those who underwent surgery in the morning (7am - 12am) and those who underwent surgery in the afternoon/night (12:01pm - 6:59am). The primary endpoints were to compare the incidence of major adverse cardiac events (MACE - acute myocardial infarction, acute heart failure, arrhythmias, and cardiovascular death) and total mortality between morning and afternoon/night surgeries within 30 days and one year. The secondary endpoint was the incidence of perioperative myocardial injury (PMI) in both groups. PMI was defined as an absolute elevation of high-sensitivity cardiac troponin T (hs-cTnT) concentrations ≥14ng/L. Multivariable analysis using Cox proportional regression (with Hazard Ratio – HR and Confidence Interval – 95% CI) was performed to adjust for confounding variables, including emergency and urgent surgeries. Results Of 1267 patients included, 1002 (79.1%) underwent vascular surgery in the morning and 265 (20.9%) in the afternoon/night. After adjusting for confounding variables, the incidence of MACE at 30 days was higher among those who underwent surgery in the afternoon/night period (37.4% vs 20.4% – HR 1.43, 95% CI: 1.10–1.85; p=0.008). Mortality rates were also elevated in the afternoon/night group (21.5% vs 9.9%, HR 1.59, 95% CI: 1.10–2.29; p=0.013). After one-year of follow-up the worst outcomes persisted in patients operated in the afternoon/night: higher incidence of MACE (37.7% vs 21.2%, HR 1.37, 95% CI: 1.06–1.78; p=0.017) and mortality (35.8% vs 17.6%, HR 1.72, 95% CI 1.31–2.27; p&lt;0.001). There was no significant difference in the incidence of PMI between groups (p=0.8). Conclusions In this group of patients, being operated in the afternoon/night period was independently associated with increased mortality rates and incidence of MACE. Mortality and MACE at one year Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): FAPESP - Fundação de Amparo a Pesquisa do Estado de São Paulo

SUMMARY OBJECTIVE To evaluate the knowledge about risk factors for cancer in patients treated at the ABC Medical School (FMABC). METHODS Cross-sectional observational study conducted in 2019. The American Cancer Institute’s Cancer Risk Awareness Survey questionnaire was used with 29 cancer risk factors, 14 of which were proven to cause cancer and 15 without consensus or scientific evidence of causality with cancer but that are often reminded by most of the population. Qualitative variables were described by frequency and percentage, and quantitative variables by mean and standard deviation or median and range depending on normality, assessed by the Shapiro-Wilk test. The study was conducted in accordance with the Helsinki Declaration for Research and approved by the Research Ethics Committee. RESULTS 191 patients were included. Median age 54 (20 to 90), 64% female. 35.6% reported current or previous smoking. 3.1% consumed alcohol more than 5 drinks/week. 56% reported sedentary lifestyle. 44% had at least 1 case of cancer in relatives up to 2nd degree. The average of correct answers in the analyzed population was 12.83 ± 3.06. A weak positive correlation was observed between income and number of cases (rho = 0.177, p = 0.02). No relationship was observed between the number of correct answers and level of education, age, sex, marital status, race or patients with a positive family history for cancer. CONCLUSION The knowledge about risk factors for cancer in the ABC population is low, which may contribute to the adoption of risk behaviors for the disease.

Introduction: Economic burden of cancer treatment does not fall only on the Brazilian National Health System (“SUS”) but also on patients. Nonreimbursed indirect costs include noncovered oral medications, food, transportation, and others. Our study compares out-of-pocket costs of cancer treatment between patients from the SUS and patients enrolled in research protocols. Methods Observational, cross-sectional and analytical study conducted in 2021. Patients undergoing chemotherapy were divided into 2 groups: patients from a tertiary hospital affiliated with the SUS and patients enrolled in research protocols at a research center. The primary outcome was the evaluation of out-of-pocket costs using a socioeconomic questionnaire to identify the cost and time spent by patients during treatment. This study was approved by the Research Ethics Committee. Results 195 patients were included, of whom 165 (84.6%) were treated by the SUS and 30 (15.4%) by research protocols. Of the total, 61% were female, and the mean age of the patients was 57 years. The median total out-of-pocket costs of SUS patients was Brazilian reais (R$) 453.80 (US$ 78.92), and that of patients who were enrolled in research protocols was R$ 448.00 (US$ 77.91) (P = 0.317). A comparison of the groups by multivariate analysis showed that only the time spent by patients on chemotherapy and radiotherapy was significantly different, being higher in the SUS group (OR 2.58, 95% CI 1.03–6.50). Conclusion Total out-of-pocket spending by SUS patients is similar in magnitude to that by patients in research protocols, although the reasons for the spending are different.