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Orientador: Paulo Traiman / Banca: Fred Ellinger / Banca: Ana Glória Pontes / Resumo: Estudo dos fatores de risco das pacientes com citologia oncológica cervical e anal alteradas. 64 pacientes encaminhadas ao Ambulatório de Colposcopia da Faculdade de Medicina de Marília-SP foram estudadas prospectivamente de fevereiro de 2006 até fevereiro de 2007, com diagnóstico citológico de HSIL. Suas histórias clínicas foram escolhidas, as citologias cervical e anal coletadas, e a colposcopia e anuscopia realizadas com Tido acético a 2%, lugol e azul de toluidina a 1%, respectivamente. A espátula de Ayres e a cytobrush foram usadas para a coleta das citologias no colo e a cytobrush, no ânus. As lâminas foram fixadas em álcool 70% e as biópsias foram realizadas com a pinça Gaylor-Medina e fixadas em formol a 10%. O Teste do Qui-Quadrado de Pearson e o Teste Exato de Fisher foram empregados para a análise estatística. Os perfis sócio-demográfico e epidemiológico das pacientes foram traçados. Nas 64 pacientes da amostra estudada, no perfilsócio-demográfico, a idade média encontrada foi de 36,6 anos. 60,9% das pacientes eram casadas; 84,4% tiveram até cinco filhos. 100% tinham baixo nível sócio-econômico. Segundo perfil epidemiológico, em média o número de parceiros sexuais foi 2,9 por paciente. A menarca ocorreu aos 12,8 anos; a coitarca, aos 16,5 anos. 76,6% das pacientes usaram método Dntraceptivo hormonal. 75% não praticavam coito anal. 70,3% não fumavam e 100% não bebiam nem usavam drogas. 68,8% colhiam citologia de rotina e 89,1% não tinham história de câncer familiar. Nas cinco pacientes com citologia anal alterada, no perfil sócioográfico, a idade média foi de 30,6 anos. 60% das pacientes eram casadas; 60% tiveram . dois filhos. 100% tinham baixo nível sócio-econômico. Segundo o perfil epidemiológico... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Study of the risk factories in the patients with changed cervical and anal oncological cytology. Methods: 64 guided patients to the Colposcopy Ambulatory from Marília Medical School (SP) were prospectively studied between February 2006 and February 2007, with HSIL cytological diagnoses. Their clinical histories were picked up, the anal and cervical cytologies were gathered and the colposcopy and the anuscopy were done with acetic acid 2%, Lugol's iodine and blue of toluidine 1%. Ayres spatula and the cytobrush were used to the cytology collects at the cervix and the cytobrush at the anus. The microscopic slides were fixed in 70% alcohol and the biopsies were done with Gaylor-Medine's pincers and fixed in formaldehyde 10%. Pearson's Chi-Squared test and Fisher Exact test were used to the statistic analyses. Results: the patients' social demography and epidemiological profile were braided. In the 64 patients from the studied sample, at the social demography profile, the medium age found was 36,6 years old. 60,9% patients were married; 84,4% had got until five children. 100% were low socio-economic leveI. At the epidemiological profile, in medium the number of sexual partners was 2,9 per patient. The menarche happened at 12,8 years old; the first coitus at 16,5 years old. 76,6% patients used hormonal contraceptive method. 75% didn't practice anal coitus. 70,3% didn't smoke and 100% patients didn't used alcohol or any drugs. 68,8% patients picked routine cytology up and 89,1% didn't have familiar cancer history. In the five patients with changed anal cytology at the social demography profile, the medium age found was 30,6 years old. 60% patients were married; 60% had got until two children. 100% were low socio-economic leveI. At the epidemiological profile, in medium... (Complete abstract click electronic access below) / Mestre

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Stela Pavlíčková Supervisor: PharmDr. Ludmila Melicharová Title of diploma thesis: Pain therapy with focus on pacients with oncological disease Pain therapy is a part of the oncological illnesses complex treatment. This therapy doesn't solve the cause of cancer, but significantly increase patient's quality of life during oncological treatment, even in the terminal stage. The main target of this work is to give basic information about pain treatment, focusing on the oncological pain, and elaborate a review of pharmacological groups and individual substances most used in oncological pain treatment. Basic pillar of the cancer pain treatment is pharmacotherapy, which goes out of the WHO three-grade analgesic ladder. Basic therapy is made of nonopioid analgesics. In case that they aren't enough, we can add weak opioids, which can be replaced by strong opioids afterwards. Analgesics are usually used repeatedly and often in combinations. Dosage interval depends on pharmacological properties, dosage form and patient condition. Well controlled pain phases are usually interrupted by very strong, cruel pain episodes, which are called break-through pain. Very strong pain, fully or partially...

Este estudo é o resultado de minha preocupação, como enfermeira, com as mulheres com câncer e que se encontram no momento fora de possibilidade de recursos para cura. Dessa forma, a trajetória deste estudo voltou-se à compreensão do significado do cuidar pela perspectiva destas mulheres. Com esta proposta, optei por realizar uma pesquisa qualitativa, segundo a abordagem fenomenológica, com base nestas questões norteadoras: - Me fale como eu posso cuidar de você. Como você gostaria de ser cuidada? Das descrições das mulheres emergiram as unificações ontológicas analisadas e interpretadas segundo o referencial de Martin Heidegger. Essas unificações possibilitaram desvelar caminhos para a ação do cuidar no processo de morrer que vão além do conhecimento técnico-científico, pois o cuidar implica também empatia, escuta, paciência, zelo, controle da dor, autonomia. Respaldada pela ótica das mulheres, foi-me permitido alcançar o sentido do ser com câncer no processo de morrer, não como algo acabado, mas como um ser de possibilidades, mesmo diante de uma situação factual que é o convívio com a terminalidade existencial. / The present study is a result of my concern, as a nurse, for women with cancer and without any possibilities of resources for a cure. Therefore, the trajectory of this study was focused on the comprehension of the meaning of taking care through those women’s perspective. For this purpose, I chose to make a qualitative survey in a phenomenological approach, based on the following directive questions: “Tell me how I can take care of you. How would you like to be taken care?". From the descriptions given by the women, it came up the ontological unifications analyzed and interpreted according to Martin Heidegger’s reference. Such unifications made it possible to reveal ways to the act of taking care in the dying process that go beyond technical-scientific knowledge, because taking care also goes through empathy, the act of listening to somebody, through patience, zeal, pain control and autonomy. Based on those women’s point of view, I was able to reach the sense of a person with cancer in the dying process, not as a finished thing, but as a person with possibilities in spite of facing a situation based on a fact, which is living with the existential end.

Šiame darbe pirmą kartą šalyje moksliškai siekiama ištirti paliatyviųjų onkologinių ir širdies ligomis sergančiųjų fizinius, psichologinius, socialinius sutrikimus bei jų ryšį su dvasingumo pokyčiais ligos metu. Darbo tikslas - nustatyti ir įvertinti paliatyviųjų pacientų sergančių onkologinėmis ir širdies ligomis fizinės, socialinės, psichinės ir dvasinės sveikatos sutrikimus ir jų sąsajas su dvasingumu. Tyrimas atliktas 5 stacionaruose, teikiančiose paliatyvią pagalbą. Tyrimas atskleidė, kad onkologinėmis ligomis sergantiems paliatyviesiems pacientams dažniausias pasireiškia: skausmas, nuovargis, fizinis silpnumas, energijos stoka, apetito sumažėjimas, svorio kritimas. Širdies ligomis sergantiems paliatyviesiems pacientams dažniausiai pasireiškia: fizinis silpnumas, dusulys, kojų tinimas, energijos netekimas, skausmas krūtinėje, nemiga. Onkologinė liga dažniau stresą sukelia jaunesnio amžiaus pacientų šeimoms. Sergantieji širdies ligomis dažniau jaučiasi izoliuoti nuo šeimos. Didžiajai daugumai onkologinių ir širdies ligomis sergančių paliatyvių pacientams nustatytas nerimastingumas ir depresiškumas, kurie nepriklauso nuo lyties, amžiaus ir išsimokslinimo. Dauguma onkologinių pacientų jaučia Dievo buvimą, viliasi išganymo iš Jėzaus Kristaus, meldžiasi už sergančius ir jaučia gilią vidinę ramybę. Moterys intensyviau išgyvena Dievo buvimą ir laikosi bažnyčios dvasinių dorybių. Dauguma sergančiųjų širdies ligomis taip pat jaučia Dievo buvimą, tačiau teigia, kad Dievas su jais... [toliau žr. visą tekstą] / There are numerous articles in the scientific literature that describe the quality of life of palliative care patients at the physical, psychological, and social levels and that mainly analyze the impact of pain control and other somatic symptoms on quality of life. However, the studies being carried out confirm that a problem in palliative care appears to be multidimensional. Most investigators emphasize only particular aspects of this problem, mostly physical, and the impact of spiritual disorders on patients’ physical symptoms as well as social and psychological health problems has not been sufficiently addressed. Spiritual health disorders often remain unrecognized due to the lack of healthcare professionals’ knowledge, or no attention at all is paid to spiritual health disorders. Thus, spiritual support is necessary in order the patient could manage a crisis and improve quality of life. The lack of such a universal theory confirms the need of further interdisciplinary holistic research, addressing not only physical, psychological, and social health problems, but spiritual health aspects as well. Therefore, it is very important to scientifically ground what physical, psychological, and social demands are and what association between them and spiritual demands is, how the patient evaluates suffering and life, whether a religious belief helps while being ill, and what the patient’s attitude toward God and hope is. This research was the first in Lithuania to analyze physical... [to full text]

Thesis (M.S.)--University of Michigan, 1984.

Thesis (M.S.)--University of Michigan, 1984.

Made available in DSpace on 2014-06-11T19:26:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-08-30Bitstream added on 2014-06-13T20:54:36Z : No. of bitstreams: 1 jose_mrf_me_botfm_prot.pdf: 2947437 bytes, checksum: 466472a456a2cd3a9b8d01f49d33fb2c (MD5) / Fundação para o Desenvolvimento Médico e Hospitalar (Famesp) / Estudo dos fatores de risco das pacientes com citologia oncológica cervical e anal alteradas. 64 pacientes encaminhadas ao Ambulatório de Colposcopia da Faculdade de Medicina de Marília-SP foram estudadas prospectivamente de fevereiro de 2006 até fevereiro de 2007, com diagnóstico citológico de HSIL. Suas histórias clínicas foram escolhidas, as citologias cervical e anal coletadas, e a colposcopia e anuscopia realizadas com Tido acético a 2%, lugol e azul de toluidina a 1%, respectivamente. A espátula de Ayres e a cytobrush foram usadas para a coleta das citologias no colo e a cytobrush, no ânus. As lâminas foram fixadas em álcool 70% e as biópsias foram realizadas com a pinça Gaylor-Medina e fixadas em formol a 10%. O Teste do Qui-Quadrado de Pearson e o Teste Exato de Fisher foram empregados para a análise estatística. Os perfis sócio-demográfico e epidemiológico das pacientes foram traçados. Nas 64 pacientes da amostra estudada, no perfilsócio-demográfico, a idade média encontrada foi de 36,6 anos. 60,9% das pacientes eram casadas; 84,4% tiveram até cinco filhos. 100% tinham baixo nível sócio-econômico. Segundo perfil epidemiológico, em média o número de parceiros sexuais foi 2,9 por paciente. A menarca ocorreu aos 12,8 anos; a coitarca, aos 16,5 anos. 76,6% das pacientes usaram método Dntraceptivo hormonal. 75% não praticavam coito anal. 70,3% não fumavam e 100% não bebiam nem usavam drogas. 68,8% colhiam citologia de rotina e 89,1% não tinham história de câncer familiar. Nas cinco pacientes com citologia anal alterada, no perfil sócioográfico, a idade média foi de 30,6 anos. 60% das pacientes eram casadas; 60% tiveram . dois filhos. 100% tinham baixo nível sócio-econômico. Segundo o perfil epidemiológico... / Study of the risk factories in the patients with changed cervical and anal oncological cytology. Methods: 64 guided patients to the Colposcopy Ambulatory from Marília Medical School (SP) were prospectively studied between February 2006 and February 2007, with HSIL cytological diagnoses. Their clinical histories were picked up, the anal and cervical cytologies were gathered and the colposcopy and the anuscopy were done with acetic acid 2%, Lugol's iodine and blue of toluidine 1%. Ayres spatula and the cytobrush were used to the cytology collects at the cervix and the cytobrush at the anus. The microscopic slides were fixed in 70% alcohol and the biopsies were done with Gaylor-Medine's pincers and fixed in formaldehyde 10%. Pearson's Chi-Squared test and Fisher Exact test were used to the statistic analyses. Results: the patients' social demography and epidemiological profile were braided. In the 64 patients from the studied sample, at the social demography profile, the medium age found was 36,6 years old. 60,9% patients were married; 84,4% had got until five children. 100% were low socio-economic leveI. At the epidemiological profile, in medium the number of sexual partners was 2,9 per patient. The menarche happened at 12,8 years old; the first coitus at 16,5 years old. 76,6% patients used hormonal contraceptive method. 75% didn't practice anal coitus. 70,3% didn't smoke and 100% patients didn't used alcohol or any drugs. 68,8% patients picked routine cytology up and 89,1% didn't have familiar cancer history. In the five patients with changed anal cytology at the social demography profile, the medium age found was 30,6 years old. 60% patients were married; 60% had got until two children. 100% were low socio-economic leveI. At the epidemiological profile, in medium... (Complete abstract click electronic access below)

Este estudo é o resultado de minha preocupação, como enfermeira, com as mulheres com câncer e que se encontram no momento fora de possibilidade de recursos para cura. Dessa forma, a trajetória deste estudo voltou-se à compreensão do significado do cuidar pela perspectiva destas mulheres. Com esta proposta, optei por realizar uma pesquisa qualitativa, segundo a abordagem fenomenológica, com base nestas questões norteadoras: - Me fale como eu posso cuidar de você. Como você gostaria de ser cuidada? Das descrições das mulheres emergiram as unificações ontológicas analisadas e interpretadas segundo o referencial de Martin Heidegger. Essas unificações possibilitaram desvelar caminhos para a ação do cuidar no processo de morrer que vão além do conhecimento técnico-científico, pois o cuidar implica também empatia, escuta, paciência, zelo, controle da dor, autonomia. Respaldada pela ótica das mulheres, foi-me permitido alcançar o sentido do ser com câncer no processo de morrer, não como algo acabado, mas como um ser de possibilidades, mesmo diante de uma situação factual que é o convívio com a terminalidade existencial. / The present study is a result of my concern, as a nurse, for women with cancer and without any possibilities of resources for a cure. Therefore, the trajectory of this study was focused on the comprehension of the meaning of taking care through those women’s perspective. For this purpose, I chose to make a qualitative survey in a phenomenological approach, based on the following directive questions: “Tell me how I can take care of you. How would you like to be taken care?”. From the descriptions given by the women, it came up the ontological unifications analyzed and interpreted according to Martin Heidegger’s reference. Such unifications made it possible to reveal ways to the act of taking care in the dying process that go beyond technical-scientific knowledge, because taking care also goes through empathy, the act of listening to somebody, through patience, zeal, pain control and autonomy. Based on those women’s point of view, I was able to reach the sense of a person with cancer in the dying process, not as a finished thing, but as a person with possibilities in spite of facing a situation based on a fact, which is living with the existential end.

A nivel nacional, Lima es el único departamento que cuenta con la mayor cantidad de oncólogos clínicos, es por ello, que niños que requieren tratamiento médico deben movilizarse a este departamento; y la gran mayoría no cuenta con solvencia económica para optar por un lugar donde alojarse. El albergue para niños con cáncer y familiares de provincia, nace como respuesta a esta necesidad; por lo que este trabajo de investigación tiene como objetivo, brindar un lugar de alojamiento para niños con cáncer que reciben tratamiento en el Instituto Nacional de Salud del Niño – San Borja. Los criterios de diseño están definidos por las necesidades que requieren los niños, y más aún con diagnóstico de cáncer, desde la estructura tipológica hasta la identificación de los espacios que ayudan en el estado de ánimo y su pronta recuperación, al igual que el énfasis de espacios intermedios que permite la relación de lo exterior e interior, aportando a una mejor solución arquitectónica. Es así que este albergue para niños con cáncer y familiares de provincia, busca brindar un aporte social y arquitectónico a los niños diagnosticados con cáncer, quienes no cuentan con un lugar que les brinde el apoyo que necesitan, y más aún si no cuentan con los medios económicos y vienen de diversas partes del Perú. / [At the national level, Lima is the only department that has the largest number of clinical oncologists, which is why children who seek medical treatment should move to this department; and the vast majority do not have the financial solvency to uproot their lives to find treatment. A shelter for children with cancer and provincial family members, could be the solution to this need; therefore, this research aims to present how to provide a place of accommodation for children with cancer receiving treatment at the National Institute of Child Health - San Borja. The criteria for design are determined by the needs that children require, and even more so with a diagnosis of cancer. From the typological structure to the identification of safe spaces that help prompt recovery, as well as the emphasis on intermediate spaces that allow the facilitate architectural solutions from within and outside the proposed project. Therefore, such a shelter for children with cancer and relatives seeks to provide a social and architectural solution to children diagnosed with cancer, who do not have a place that provides the support they need, especially if they do not have the economic means to relocate near medical providers. / Trabajo de investigación