ABSTRACT
Introdução: No contexto do Sistema Único de Saúde, o conceito da prevenção quaternária adentra timidamente os níveis de atenção à saúde, no entanto, sofre expansão significativa no âmbito da atenção primária à saúde. Objetivo: Identificar por meio da sistematização de evidências científicas, as contribuições técnicas e socioculturais da prevenção quaternária no âmbito da atenção primária à saúde no Brasil. Métodos: Trata-se de uma revisão integrativa de estudos presentes nas bases de dados científicas da Scientific Electronic Library Online, Biblioteca Virtual em Saúde, biblioteca virtual da Comissão de Aperfeiçoamento de Pessoal do Nível Superior e MEDLINE via PubMed com a utilização dos descritores "prevenção quaternária" e "atenção primária à saúde", em inglês e português. Resultados: O corpus de análise foi composto por 22 artigos, sendo que a produção científica sobre o tema se deu de forma mais intensa a partir do ano de 2015 e, em sua maioria, possuíam como abordagem metodológica ensaios teóricos. Dentre as contribuições técnicas destacaram-se a introdução do ensino da prevenção quaternária de modo continuado aos graduandos e profissionais; a construção de protocolos e documentos de amparo profissional; a utilização de modelos explicativos dinâmicos na socialização do quadro clínico; a conduta profissional com os usuários e as contribuições socioculturais envolvendo mudanças na percepção profissional e comunitária sobre o fenômeno saúde-doença, assim como o incentivo a práticas de desmedicalização sociocultural em relação à dor, incapacidade, desconforto, envelhecimento, nascimento e morte. Conclusão: Apesar do reconhecimento das potencialidades da prevenção quaternária, faz-se necessário fortalecer estratégias que possibilitem o desenvolvimento de políticas públicas para fomentar e gerenciar alianças estratégicas com tomadores de decisão, profissionais de saúde e cidadãos, para fomentar a redução de diagnósticos e tratamentos excessivos, contribuindo com a qualidade do cuidado.
Introduction: In the context of the Unified Health System, the concept of quaternary prevention shyly enters the levels of health care, however, undergoes significant expansion in the scope of primary health care. Objective: To identify, through the systematization of scientific evidence, the technical and socio-cultural contributions of quaternary prevention within the scope of primary health care in Brazil. Methods: This is an integrative review of studies present in the scientific databases of the Scientific Electronic Library Online, Regional Portal of the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information of the Pan American Health Organization, virtual library of the Higher Education Personnel Improvement Commission, and MEDLINE through PubMed using the descriptors "quaternary prevention" and "primary health care", in English and Portuguese. Results: The corpus of analysis consisted of 22 articles, and the scientific production on the topic took place more intensively from the year 2015 and, for the most part, had theoretical essays as methodological approach. Among the technical contributions, we highlight the introduction of teaching on quaternary prevention in a continuous way to undergraduates and professionals; the construction of protocols and documents of professional support; the use of dynamic explanatory models in the socialization of the clinical picture and professional conduct with users and socio-cultural contributions involve changes in the professional and community perception about the phenomenon of illness and health conception, as well as the incentive to practices of socio-cultural demedicalization in relation to pain, disability, discomfort, aging, birth, and death. Conclusion: Despite the recognition of the potential of quaternary prevention, it is necessary to strengthen strategies that enable the development of public policies to foster and manage strategic alliances with decision makers, health professionals and citizens, to promote the reduction of excessive diagnoses and treatments, contributing to the quality of care.
Introducción: En el contexto del Sistema Único de Salud, el concepto de prevención cuaternaria entra tímidamente en los niveles de atención de salud, sin embargo, experimenta una expansión significativa en el alcance de la Atención Primaria de Salud. Objetivo: Identificar, a través de la sistematización de evidencia científica, las contribuciones técnicas y socioculturales de la prevención cuaternaria en el ámbito de la Atención Primaria de Salud en Brasil. Métodos: Esta es una revisión integradora de estudios presentes en las bases de datos científicas de la Biblioteca Electrónica Científica en línea, Portal Regional de la Biblioteca Virtual en Salud del Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud de la Organización Panamericana de la Salud, biblioteca virtual de la Comisión de Mejoramiento del Personal de Educación Superior y MEDLINE a través de PubMed utilizando los descriptores de prevención cuaternaria y atención primaria de salud, en inglés y portugués. Resultados: El corpus de análisis estuvo conformado por 22 artículos, siendo la producción científica sobre el tema más intensiva desde 2015 y, en su mayor parte, tuvo ensayos teóricos como abordaje metodológico. Entre los aportes técnicos, destacamos la implantación de la docencia en prevención cuaternaria de forma continua a estudiantes de pregrado y profesionales; construcción de protocolos y documentos de apoyo profesional, uso de modelos explicativos dinámicos en la socialización del cuadro clínico y conducta profesional con los usuarios y los aportes socioculturales implican cambios en la percepción profesional y comunitaria sobre el fenómeno de la enfermedad y la concepción de la salud, así como el incentivo a prácticas de desmedicalización sociocultural en relación al dolor, discapacidad, malestar, envejecimiento, nacimiento y muerte. Conclusión: A pesar del reconocimiento del potencial de la prevención cuaternaria, es necesario fortalecer estrategias que permitan el desarrollo de políticas públicas para fomentar y gestionar alianzas estratégicas con los tomadores de decisiones, profesionales de la salud y ciudadanos, para promover la reducción de diagnósticos y tratamientos excesivos, contribuyendo a la calidad de la atención.
Subject(s)
Primary Health Care , Unified Health System , Family Practice , Medical Overuse , Quaternary PreventionABSTRACT
The 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, which took place May 31-June 4 in Chicago, drew more than 32,000 oncology specialists from around the world. The theme of 2019 ASCO conference was “Caring for Every Patient, Learning from Every Patient”. Among the topics of interest covered were new approaches to surmount limited access to cancer care and the latest advances in targeted therapies for pancreatic, prostate cancers and soft tissue sarcomas. In the field of head and neck cancer, 8 oral abstracts and 75 poster abstracts were presented at this meeting. In this review, we are going to summarize the eight studies that have been presented orally. The topics are recurrent and/or metastatic head and neck squamous cell carcinoma for two abstracts (#6000, #6002), salivary duct carcinoma for one abstract (#6001), locally advanced nasopharyngeal carcinoma for two abstracts (#6003, #6004), oropharyngeal carcinoma for two abstracts (#6006, #6008), and oral cavity cancer for one abstract (#6007).
Subject(s)
Humans , Carcinoma, Squamous Cell , Head , Head and Neck Neoplasms , Learning , Medical Oncology , Mouth , Neck , Prostatic Neoplasms , Salivary Ducts , Sarcoma , SpecializationABSTRACT
In this July issue of Clinical Endoscopy, state-of-the-art articles selected from the lectures delivered during the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 29, 2015 are covered, focusing on highlighted educational contents relevant to either diagnostic or therapeutic gastrointestinal (GI) endoscopy. Our society, the KSGE, has continued to host this opportunity for annual seminars twice a year over the last 26 years and it has become a large-scale prestigious seminar accommodating over 4,000 participants. Definitely, the KSGE seminar is considered as one of the premier state-of-the-art seminars dealing with GI endoscopy, appealing to both the beginner and advanced experts. Lectures, live demonstrations, hands-on courses, as well as an editor school, which was an important consensus meeting on how to upgrade our society journal, Clinical Endoscopy, to a Science Citation Index (Expanded) designation were included in this seminar. The 52nd KSGE seminar consisted of more than 20 sessions, including special lectures, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. This is a very special omnibus article to highlight the core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized sessions.
Subject(s)
Humans , Consensus , Endoscopy , Endoscopy, Gastrointestinal , Lecture , Lower Gastrointestinal Tract , Upper Gastrointestinal TractABSTRACT
The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses.
Subject(s)
Endoscopy , Endoscopy, Gastrointestinal , Lecture , Lower Gastrointestinal Tract , Publications , Upper Gastrointestinal TractABSTRACT
This special May issue of Clinical Endoscopy discusses the tutorial contents dealing with either the diagnostic or therapeutic gastrointestinal (GI) endoscopy that contain very fundamental and essential points in this filed. The seminar of Korean Society of Gastrointestinal Endoscopy (KSGE) had positioned as one of prime educational seminars covering the very beginner to advanced experts of GI endoscopy. Besides of four rooms allocated for each lecture, two additional rooms were open for either live demonstration or hands-on course, covering totally 20 sessions including one special lecture. Among these prestigious lectures, 12 lectures were selected for the current review articles in this special issue of Clinical Endoscopy journal. Basic course for beginner to advanced tips to expert were all covered in this seminar. This introductory review prepared by four associated editors of Clinical Endoscopy contained core contents divided into four sessions-upper gut, lower gut, pancreaticobiliary, and specialized topic session part-to enhance understandings not covered by enlisted review articles in this issue.
Subject(s)
Endoscopy , Endoscopy, Gastrointestinal , LectureABSTRACT
Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy.
Subject(s)
Endoscopy , Endoscopy, Gastrointestinal , Joints , Korea , LectureABSTRACT
Objetivo: Relacionar las imágenes de los adenomas obtenidos mediante RM para su mejor caracterización mediante un protocolo de alta resolución. Material y Métodos: Se analizaron retrospectivamente 86 RM de la región selar realizadas en el Hospital Obrero N°1, y se las relacionó con el tipo de realce post contraste paramagnético y signos de compresión. Se estudiaron 72 mujeres y 14 hombres, con un promedio de 43 años. Las exploraciones se realizaron utilizando un Magneto Signa 1,5 T, con cortes sagitales y coronales ponderados en T1 sin y con contraste paramagnético. Resultados: El 67,5% (58 pacientes) presentó adenoma hipofisiario. De estos el 51.1% fueron tipo microadenoma y el 48.3% macroadenoma. El 53,3% de los microadenomas y el 14,3% de los macroadenomas presentaban hiperprolactinemia. El 100% de los macroadenomas presentaron realce heterogéneo tras la administración del medio de contraste. Los microadenomas presentaron realce homogéneo en el 76,6%. El 85,7% de los macroadenomas y el 16,7% de los microadenomas presentaron obliteración de la cisterna supraselar. El 85,7% de los macroadenomas y en el 10% de los microadenomas, produjeron desplazamiento del quiasma óptico. El 64,3% de los macroadenomas y en el 20,7% de los microadenomas, invadieron el seno cavernoso y desviaron el tallo hipofisiario. Conclusión: La RM es el método imagenológico de elección para el estudio de la hipófisis gracias a su caracterización anatómica y funcional, especialmente cuando se utiliza gadolinio.
Objective: To relate the images of adenomas obtained by MRI for further characterízation using a high-resolution protocol Material and Methods: We analyzed 86 MRI retrospectivamen the sellar region in the Hospital Obrero No. 1 and are related to the type of contrast enhancement after paramagnetic and signs of compression. We studied 72 women and 14 men with an average of 43 years gave. The scans were performed using Magneto do a 1.5 T Signa, with cut-weighted sagittal and coronal T1 with and without paramagnetic contrast. Results: 67.5% (58 patients) had pituitary adenoma. Of these the kind microadenomas were 51.1% and 48.3% macroadenoma. 53.3% of microadenomas and 14.3% of macroadenomas had hyperprolactinemia. 100% of the macroadenomas showed heterogeneous enhancement after administration of contrast medium. The microadenomas showed homogeneous enhancement in 76.6%. The 85.7% of macroadenomas and 16.7% of microadenomas showed obliteration of the tank supraselar. The 85.7% of macroadenomas and10% of microadenomas, produced displacement of optic chiasm. 64.3% of macroadenomas and 20.7% of microadenomas, invaded the cavernous sinus and diverted the pituitary stalk. Conclusión: MRI is the imaging method of choicefor the study of the pituitary due to its characterisation in anatomy and function especially when using gadolinium.