A residência médica em medicina do trabalho na faculdade de medicina da universidade de São Paulo / The medical residency in occupational medicine of medical school of university of São Paulo

Objetivo: Descrever as características e a evolução do Programa de Residência Médica em Medicina do Trabalho na Faculdade de Medicina da Universidade de São Paulo (PMT-FMUSP), desde o seu credenciamento em 2004 até 2010.Método: Estudo descritivo retrospectivo, com base numa revisão bibliográfica de textos institucionais, artigos, e teses e também na análise de documentos arquivados pelo referido Programa e de entrevistas com seus participantes. Resultados: O PMT-FMUSP foi credenciado em 2004 prevendo 5760 horas de treinamento em serviço, divididas em dois anos letivos, com duas vagas. No período de 2004 a 2010, concluíram a residência seis médicos do trabalho. Foram realizadas atividades práticas concentradas nos ambulatórios e serviços de emergência do Hospital das Clínicas da Faculdade, estágios em serviços especializados de empresas privadas de diversos ramos de atividade econômica, sindicatos de trabalhadores e em órgãos públicos relacionados com a saúde dos trabalhadores. As atividades teórico-práticas incluíram aulas no Curso de Especialização de Medicina do Trabalho da Faculdade e reuniões científicas com discussões de casos ou artigos referentes à saúde dos trabalhadores. Conclusão: O PMT-FMUSP é recente e cumpre os requisitos mínimos previstos pela Comissão Nacional de Residência Médica. Ao longo do período em análise, sofreu alterações relacionadas à incorporação de locais de estágios como processo normal de amadurecimento de forma a dotar o médico do trabalho das competências necessárias para o exercício da medicina do trabalho no Brasil.

Aim: Describe the characteristics and the evolution of the Program of Medical Residency in Occupational Medicine of Medical School of University of São Paulo (PMT-FMUSP), since its accreditation in 2004 until 2010. Method: A retrospective descriptive study based on a bibliographic review of institutional texts, articles and theses and also on the analysis of documents filed by the Program and interviews with the participants. Results: The PMT-FMUSP was accredited in 2004 predicting 5760 hours of service training, divided in two academic years, with two vacancies.Between 2004 and 2010, six occupational doctors graduated. The practical activities were concentrated in the ambulatories and emergency services of the College Hospital, internships in specialized services of private companies which operate in different areas of the economy, labor union and in government agencies related to the workers health. The theorical-practical activities included classes in the Specialization Course of Occupational Medicine of the University and in scientific meetings with discussions about clinical cases or articles about Workers Health. Conclusion: The PMT-FMUSP is recent and fulfills the minimum requirements according to the National Committee of Medical Residency. During the period in analysis, the course suffered changes in its structure, part of a normal process of maturing in a way to give the occupational doctor the necessary abilities for the practice of occupational medicine in Brazil.

Gastric and colorectal cancer mortality in an urban and industrialized area of Brazil

PURPOSE: To study the gastric and colorectal cancer mortalities and their relation to the urban-industrialization in Baixada Santista, located in the southeastern region of Brazil. METHODS: Selected from the registries of the State System of Data Analysis Foundation (SEADE) were 1105 deaths due to gastric cancer (ICD 153--154) and 690 due to colorectal cancer (ICD 151) that occurred from 1980 to 1993 in males, above 10 years of age, residing in Baixada Santista. For each of these types of cancer, the standardized mortality rates, age-adjusted by world population in the 1960s, for 4 industrialized and 4 non-industrialized urban communities in that region were calculated. The ratios among those rates were calculated in order to compare the mortality in the periods 1980--93, 1980--1986, and 1987--1993. RESULTS: Standardized mortality rates for colorectal cancer were significantly higher in industrialized area, with ratios of 1.6 [95 percent CI 1.22 -- 2.29], 1.6 [95 percent CI 1.2 -- 2.0], and 1.6 [95 percent CI 1.3 -- 2.0] in the periods 1980--86, 1987--1993 and 1980--93, respectively. Gastric cancer did not show any statistical difference between the industrialized and non-industrialized areas, but there was a significant decrease in BS from the period 1980--1986 to 1987--1993. CONCLUSIONS: The significant elevation of colorectal cancer mortality in the industrialized area could be related to exposure to numerous carcinogens such as aromatic hydrocarbon, organic-chloride, metals, and industrial-port dust present in the region. Alternatively, the non-significant difference in gastric cancer between industrialized and non-industrialized areas and significant decrease in the last few years could be predominately reflecting the advances in the quality of life in urban areas. These results require further case-control studies that could help with the analysis of the associations among cancer and environmental factors (occupational, urban-industrial, habit, and life condition) and genetic susceptibility