Thèse. Faculté de medécine de Paris, June 4, 1860.

Thesis (Doctoral).--Université de Montpellier, 1908, no. 28.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Washington, 1990. / Vita. Includes bibliographical references (leaves [78]-89).

Os tumores de endométrio fazem parte do espectro de tumores de inúmeras síndromes neoplásicas hereditárias (SNH). Entretanto, tais tumores, quando proficientes para o sistema de reparo incorreto de DNA (MMR), geralmente são classificados como cânceres esporádicos. Contudo, mesmo diante de uma provável classificação esporádica, a história familiar (HF) de portadoras dessas neoplasias pode apresentar indícios de componentes genéticos hereditários associados ao seu desenvolvimento. Para tanto, tivemos como objetivo principal, caracterizar a HF de mulheres diagnosticadas com tumores de endométrio, com estabilidade de microssatélites, proficientes para o sistema de reparo de pareamento incorreto de DNA, com a finalidade de avaliar o seu risco para síndromes neoplásicas hereditárias. Trata-se de um estudo descritivo de caráter populacional. A amostra inicial (n=58) foi acessada e caracterizada por meio da colaboração com um estudo maior, que investigou tumores de endométrio, quanto à proficiência do sistema de reparo MMR em uma casuística brasileira, a partir de dados coletados no biobanco do Serviço de Patologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. A coleta da HF teve início em abril de 2018 e foi finalizada em julho do mesmo ano. Nossa casuística final foi composta por 42 mulheres que atenderam aos critérios de inclusão/exclusão. Por meio de contato telefônico foi aplicado o Questionário de Rastreamento Primário e, posteriormente, desenhado o heredogramas das famílias, com a utilização do software PedigreeDraw. Após a coleta e o registro da HF, os heredogramas foram analisados pela pesquisadora principal deste trabalho e as famílias foram classificadas quanto ao seu risco de possuírem uma SNH. Nosso estudo possibilitou a identificação de 27 mulheres (64% da nossa casuística) que podem estar em risco para SNH. Dentre essas, no que se refere às SNH que têm o câncer colorretal no seu espectro de tumores, 26% preencheram critérios de Bethesda e 15% preencheram critérios de Amsterdam, sendo que 4% preencheram critérios para FAP atenuada. Já 11% preencheram critérios para síndrome de Câncer de Mama e Ovário Hereditários e 22% preencheram critérios para síndrome Li-Fraumeni Like tipo 1. Ressaltamos que 33% apresentaram história pessoal de câncer abaixo dos 50 anos. Os resultados aqui apresentados reforçam a importância da HF e precisam encorajar os profissionais de saúde a realizar com maior frequência a coleta e o registro da HF, ainda que seja autorreferida. Mesmo diante das novas tecnologias genômicas e do crescente conhecimento dos aspectos genéticos e de testes, a HF continua a destacar informações de risco, extremamente significativas, que vão além da suscetibilidade genética. Portanto, os indivíduos e suas famílias devem ser acompanhados com base na história pessoal e familiar para identificação de suspeitas de SNH / Endometrial tumors are part of the spectrum of tumors of innumerable hereditary neoplastic syndromes (SNH). However, such tumors, when proficient for the DNA mismatch repair (MMR), are usually classified as sporadic cancers. However, even though they are characterized as sporadic, the family history (HF) of carriers of these neoplasms may present evidence of hereditary genetic components associated with its onset and development. In order to study such evidences, we aimed to characterize the HF of women diagnosed with endometrial tumors and microsatellite stability, proficient for the DNA mismatch repair system, in order to evaluate their risk for hereditary neoplastic syndromes. This is a descriptive population-based study. The initial sample (n = 58) was reached and characterized by collaboration with a larger study, which investigated endometrial tumors, regarding the proficiency of the MMR system in a Brazilian sample. We collected data in the Pathology Center of the Hospital das Clínicas of the Medical School of Ribeirão Preto of the University of São Paulo. The HF collection began in April 2018 and was completed in July of the same year. Our final sample consisted of 42 women who met the inclusion / exclusion criteria. By telephone, the Primary Tracking Questionnaire was applied and, afterwards, the families\' pedigrees were drawn using the PedigreeDraw software. After HF collection and registration, the pedigrees were analyzed by the main researcher of this study and the families were classified according to their risk of having an NHS. Our study allowed the identification of 27 women (64% of our sample) who may be at risk for SNH. For samples who have colorectal cancer in their tumor spectrum and suspicion for NHS, 26% met Bethesda criteria and 15% met Amsterdam criteria, and 4% met criteria for attenuated FAP. 11% of our sample met criteria for Hereditary Breast and Ovarian Cancer syndrome and 22% met criteria for Li-Fraumeni Like type 1 syndrome. We pointed out that 33% had a personal history of cancer under 50 years. The results presented here support the importance of HF and the need to encourage health professionals to perform HF collection and registration more frequently, even if it is self-referenced. Even in the face of new genomic technologies and growing knowledge of genetic and testing aspects, HF continues to highlight extremely significant risk information beyond genetic susceptibility. Therefore, not only the individuals but also their families should be monitored on the basis of personal and family history to identify suspected SNH

No description available.

Leung, Winnie. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 155-164). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgements --- p.v / Table of Contents --- p.vi / List of Figures --- p.x / Abbreviations --- p.xii / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Clinical management of Cancer --- p.2 / Chapter 1.2 --- Multidrug resistance --- p.8 / Chapter 1.3 --- Aim of study --- p.14 / Chapter Chapter 2 --- Identification of gene contributing to multidrug resistance in human uterine sarcoma cells --- p.16 / Chapter 2.1 --- Introduction --- p.17 / Chapter 2.2 --- Material and Methods / Chapter 2.2.1 --- Materials / Chapter 2.2.1.1 --- Cell lines --- p.20 / Chapter 2.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.20 / Chapter 2.2.1.3 --- Gene expression assay reagents --- p.22 / Chapter 2.2.1.4 --- Western blotting reagents --- p.24 / Chapter 2.2.1.5 --- MTT assay reagents --- p.29 / Chapter 2.2.1.6 --- Apoptosis analysis by flow cytometry reagents --- p.29 / Chapter 2.2.2 --- Metho --- p.ds / Chapter 2.2.2.1 --- Cell Culture --- p.31 / Chapter 2.2.2.2 --- MTT assay --- p.32 / Chapter 2.2.2.3 --- Gene expression essay (RT-PCR) --- p.33 / Chapter 2.2.2.4 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.37 / Chapter 2.2.2.5 --- Quantification of doxorubicin uptake by flow cytometry --- p.40 / Chapter 2.2.2.6 --- Apoptosis analysis by flow cytometry --- p.41 / Chapter 2.3 --- Results --- p.4 / Chapter 2.3.1 --- Cytotoxicity of doxorubicin on SA and DX5 cells --- p.43 / Chapter 2.3.2 --- mRNA expression of multidrug resistance related genes in SA and DX5 cells --- p.46 / Chapter 2.3.3 --- P-glycoprotein expression in SA and DX5 cells --- p.49 / Chapter 2.3.4 --- Doxorubicin (Dox) uptake by SA and DX5 cells --- p.51 / Chapter 2.3.5 --- Doxorubicin induced Apoptosis in SA and DX5 cells --- p.54 / Chapter 2.4 --- Discussion --- p.61 / Chapter 2.5 --- Conclusion --- p.65 / Chapter Chapter 3 --- Alternation in P-glycoprotein expression in DX5_Ninjl cells --- p.66 / Chapter 3.1 --- Introduction --- p.67 / Chapter 3.2 --- Materials and Methods / Chapter 3.2.1 --- Materials / Chapter 3.2.1.1 --- Cell lines --- p.70 / Chapter 3.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.70 / Chapter 3.2.1.3 --- Gene expression assay reagents --- p.70 / Chapter 3.2.1.4 --- Western blotting reagents --- p.72 / Chapter 3.2.1.5 --- Plasmid DNA extraction --- p.75 / Chapter 3.2.1.6 --- Transient transfection --- p.76 / Chapter 3.2.1.7 --- MTT reagents --- p.76 / Chapter 3.2.2 --- Methods / Chapter 3.2.2.1 --- Cell culture --- p.78 / Chapter 3.2.2.2 --- Gene expression essay (RT-PCR) --- p.79 / Chapter 3.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.81 / Chapter 3.2.2.4 --- DNA plasmid extraction --- p.83 / Chapter 3.2.2.5 --- Transient transfection --- p.84 / Chapter 3.2.2.6 --- MTT assay --- p.85 / Chapter 3.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.86 / Chapter 3.3 --- Results / Chapter 3.3.1 --- mRNA expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.87 / Chapter 3.3.2 --- The protein expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.89 / Chapter 3.3.3 --- Ninjurin1 (Ninj1) cDNA transfection in DX5 cells --- p.91 / Chapter 3.3.4 --- mRNA expression of MDR1 in Ninjurin1-transfected DX5 cells (DX5_Ninjl) --- p.93 / Chapter 3.3.5 --- P-glycoprotein expression in Ninjurin1-transfected DX5 cells --- p.95 / Chapter 3.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5_Ninjl cells" --- p.97 / Chapter 3.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_Ninjl cells" --- p.99 / Chapter 3.4 --- Discussion --- p.102 / Chapter 3.5 --- Conclusion --- p.105 / Chapter Chapter 4 --- Alternation in MDR1 expression in DX5一THBS1 cells --- p.106 / Chapter 4.1 --- Introduction --- p.107 / Chapter 4.2 --- Materials and Methods / Chapter 4.2.1 --- Materials / Chapter 4.2.1.1 --- Cell lines --- p.109 / Chapter 4.2.1.2 --- Cell culture medium； supplements and buffers --- p.109 / Chapter 4.2.1.3 --- Gene expression assay reagents --- p.109 / Chapter 4.2.1.4 --- Western blotting reagents --- p.111 / Chapter 4.2.1.5 --- Plasmid DNA extraction --- p.114 / Chapter 4.2.1.6 --- Transient transfection --- p.115 / Chapter 4.2.1.7 --- MTT reagents --- p.115 / Chapter 4.2.2 --- Methods / Chapter 4.2.2.1 --- Cell culture --- p.117 / Chapter 4.2.2.2 --- Gene expression essay (RT-PCR) --- p.118 / Chapter 4.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.120 / Chapter 4.2.2.4 --- DNA plasmid extraction --- p.123 / Chapter 4.2.2.5 --- Transient transfection --- p.123 / Chapter 4.2.2.6 --- MTT assay --- p.124 / Chapter 4.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.125 / Chapter 4.3 --- Results / Chapter 4.3.1 --- mRNA expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.126 / Chapter 4.3.2 --- The protein expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.128 / Chapter 4.3.3 --- Thrombospondinl (THBS1) cDNA transfection in DX5 cells --- p.130 / Chapter 4.3.4 --- mRNA expression of MDR1 in Thrombospondinl-transfected DX5 cells (DX5_THBS1) --- p.132 / Chapter 4.3.5 --- P-glycoprotein expression in Thrombospondinl-transfected DX5 cells --- p.134 / Chapter 4.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5一THBS1 cells" --- p.136 / Chapter 4.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_THBS1 cells" --- p.138 / Chapter 4.4 --- Discussion --- p.141 / Chapter 4.5 --- Conclusion --- p.145 / Chapter Chapter 5 --- General discussion --- p.146 / Chapter 5.1 --- Doxorubicin induced multidrug resistance in human uterin sarcoma cells via upregulation of P-glycoprotein --- p.147 / Chapter 5.2 --- The down-regulation of Ninjurin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.148 / Chapter 5.3 --- The down-regulation of Thrombospondin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.150 / Chapter 5.4 --- Conclusion and Future Perspective --- p.153 / Reference --- p.155

Made available in DSpace on 2015-12-06T23:47:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2007 / O câncer de colo de útero é o mais comum entre as mulheres no mundo. No Brasil, estima-se que seja a terceira neoplasia maligna encontrada entre mulheres. Pode ser prevenido se for detectado precocemente, há necessidade de sua conscientização por meio da educação em saúde, que pode auxiliar as mulheres a terem maior autonomia sobre seu corpo e saúde. Com o propósito de contribuir para a melhoria na promoção da saúde de mulher, este trabalho teve o objetivo de construir e validar material educativo com orientações passo a passo sobre a importância e realização do exame de Papanicolaou para usuárias de serviços públicos de saúde da cidade de São Paulo/Brasil. Trata-se de pesquisa descritiva, exploratória e observacional que se propôs construir um folder com orientações para prevenção do câncer cérvico-uterino para mulheres, tendo como referencial teórico a educação de adultos. Sua construção foi realizada com as mulheres, utilizando-se linguagem e desenhos de fácil compreensão. Foi avaliado por oito profissionais especialistas na área. Realizadas as modificações sugeridas, ele foi reproduzido e validado por 96 usuárias de unidades básicas de saúde da cidade de São Paulo. Os resultados da validação revelam que as mulheres consideraram por unanimidade o texto interessante com frases de fácil compreensão, ilustrações simples que facilitaram seu entendimento. A grande maioria teve o interesse em ler o folder até o final que as fez repensar sobre sua saúde. As mulheres expressaram a boa qualidade do material, verbalizando o interesse em levá- lo para casa. Concluiu-se que o material educativo construído e validado poderá colaborar na produção do conhecimento das mulheres que freqüentam unidades de saúde e contribuir para o recrutamento da população para realização desse exame simples e indispensável para prevenção do câncer cérvico-uterino com o objetivo de contribuir para diminuição dos índices de morbimortalidade feminino por câncer. / The cancer of the cervix of the uterus is the most common among the women in the world. In Brazil, it is supposed to be the third malignant neoplasia found among women. It can be prevented if detected precociously. It is necessary to aware people through health education so that it can help women to be more autonomous concerning their body and health. With the purpose of contributing to improvement in women health promotion, this paper had the aim of building and validating educational material with step by step orientations about the importance and accomplishment of Papanicolaou exam to public health service users of São Paulo city in Brazil. It is a descriptive, exploratory and observational research with the purpose of developing a folder with orientation about the cancer of the uterine cervix to women, having as theoretical reference the adults' education. Its production was done with women, using language and drawings easily understood. It was analyzed by eight specialists in the area. After the proper changes, the folder was printed and validated by 96 users of the basic health units of São Paulo city. The results of acceptance reveal that all the women considered the text interesting with easy understandable sentences and simple illustration which helped their comprehension. The majority was interested in reading the text until the end which made them to rethink their health. The women expressed the good quality of the material when they said they were interested in taking it home. It was concluded that the educational material produced and validated will be able to help in the knowledge production of women that usually go to health public bases and contribute to the population recruiting and accomplishment of this simple and indispensable exam to uterine cervical cancer that must help a lot to minimize the female diseases and mortality rates by cancer. / BV UNIFESP: Teses e dissertações

Orientador: Maria de Lourdes da Silva Marques Ferreira / Resumo: O câncer de colo do útero constitui, em todo o mundo, um sério problema de saúde pública e pode acometer especialmente mulheres de nível socioeconômico baixo e na faixa etária reprodutiva. Este estudo trata-se de uma pesquisa na abordagem qualiquantitativa com objetivo geral de compreender a percepção da vulnerabilidade à doença entre mulheres com diagnóstico de câncer de colo do útero e com objetivos específicos de levantar o conjunto de características individuais, sociais e programáticas presentes no cotidiano das mulheres, participantes deste estudo, que as tornaram vulneráveis ao câncer de colo do útero; identificar os motivos que contribuíram para a percepção da vulnerabilidade de mulheres com a doença; verificar as mudanças na vida das mulheres percebidas por elas após o diagnóstico de câncer de colo do útero; apreender as representações do câncer de colo do útero atribuídas pelas mulheres com esta neoplasia; identificar as facilidades e as barreiras, na visão dessas mulheres, voltadas para o seguimento e assistência ao tratamento do câncer de colo do útero; conhecer a forma de participação destas mulheres no tratamento do câncer de colo do útero. A pesquisa foi conduzida com 38 mulheres que possuíam diagnóstico confirmado de câncer de colo do útero em tratamento no Ambulatório de Ginecologia Oncológica do Hospital das Clínicas da Faculdade de Medicina de Botucatu/UNESP. A técnica de coleta de dados foi a entrevista e o registro dos dados em instrumento elaborado pela ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cervical cancer is a serious public health problem throughout the world and mainly affecting women of low socioeconomic status and to reproductive age. This is a qualiquantitative study with a general objective of understanding the perception of vulnerability among women diagnosed with cervical cancer and with specific objectives were: listing the individual, social and programmatic characteristics of the daily lives of women participating in this study that make them vulnerable to cervical cancer; identifying the reasons that contributed to the perception of vulnerability in women with the disease; verifying the life changes perceived by them after cervical cancer diagnosis; apprehending the representations of cervical cancer attributed by women with this neoplasm; identifying the facilities and barriers, in their point of view, aimed at the follow-up and assistance in the cervical cancer treatment; the participation of these women in the treatment of cervical cancer. This study included 38 women who had a confirmed diagnosis of cervical cancer and treated at the Oncology Gynecology Clinic in the Clinical Hospital Botucatu Medical School. The data collection technique was the interview and whose responses were recorded digitally in an instrument prepared by the researcher. The discourse of the collective subject was used as a methodological reference while the vulnerability in the framework of human rights and the theory of social representations were used as theoretical ref... (Complete abstract click electronic access below) / Doutor

Made available in DSpace on 2014-12-17T14:47:00Z (GMT). No. of bitstreams: 1 DanyellaARSC_DISSERT.pdf: 1002089 bytes, checksum: 8c39650c4f2757b157f3ced0428ababb (MD5) Previous issue date: 2013-06-21 / Universidade Federal do Rio Grande do Norte / Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN. / O c?ncer do colo do ?tero (CCU) ? a segunda neoplasia mais prevalente entre as mulheres brasileiras. Os elevados ?ndices de CCU no Brasil justificam a implementa??o de estrat?gias efetivas para o controle deste, que incluem a??es de promo??o ? sa?de; preven??o prim?ria; detec??o precoce; rastreamento; tratamento e cuidados paliativos. Apesar da exist?ncia do Programa Nacional de Controle do CCU n?o houve redu??o na incid?ncia e mortalidade dessa doen?a no Brasil. A Estrat?gia Sa?de da Fam?lia (ESF) apresenta potencialidades para promover esse controle e, neste contexto, deve-se considerar que os enfermeiros t?m papel central. O estudo teve por objetivo geral conhecer as estrat?gias de interven??o utilizadas por enfermeiros da ESF do munic?pio de Natal/RN no controle do CCU, e como espec?ficos: analisar o conhecimento desses enfermeiros sobre o CCU, descrever as a??es desenvolvidas na ESF para o controle do CCU e identificar as dificuldades enfrentadas pelos mesmos para realiz?-la. Trata-se de um estudo descritivo explorat?rio, quantitativo desenvolvido por meio de um roteiro de entrevista estruturada com 106 enfermeiros que t?m experi?ncia no controle do CCU nas equipes de ESF de Natal/RN. A an?lise dos dados foi realizada por meio da estat?stica descritiva. Os resultados apontaram como a??es desenvolvidas na ESF para o controle do CCU, coleta do exame citopatol?gico, atividades de educa??o em sa?de, consulta de enfermagem, encaminhamento de casos suspeitos para o acompanhamento m?dico e busca ativa de mulheres com o resultado do exame alterado. As a??es que n?o foram citadas pelos enfermeiros constam de: forma??o de grupos de preven??o e promo??o ? sa?de; amplia??o da cobertura dos exames e do hor?rio de atendimento das consultas; estabelecimento de alternativas para acabar com a demanda reprimida nas Unidades de Sa?de; participa??o no tratamento ou processo de reabilita??o de usu?rias com o CCU; interven??es para o manejo da dor; alian?as e parcerias com escolas, ind?strias e utiliza??o de protocolos de atendimento. Com este estudo pode-se perceber que os enfermeiros praticam parcialmente a??es para o CCU no munic?pio de Natal/RN. Os participantes deste estudo, quando questionados sobre o CCU, especificamente quanto aos sinais e sintomas da doen?a e os fatores de risco, de forma geral apresentaram lacunas importantes. Dificuldades, como falta de material para coleta do exame preventivo; espa?o f?sico inadequado nas Unidades de Sa?de; demanda reprimida no servi?o; atraso na chegada do resultado dos exames; entraves nas a??es de refer?ncia e contra-refer?ncia e fatores culturais fazem com que o controle do CCU seja comprometido. Acredita-se com esta investiga??o contribuiu para uma reflex?o sobre a import?ncia do papel dos enfermeiros da ESF no desenvolvimento das a??es de controle do CCU, apontando os fatores que interferem nestas. ? importante o envolvimento de todos os enfermeiros que comp?em a ESF como conhecedores dos fatores de risco, sinais e sintomas e dos instrumentos existentes para a detec??o precoce do CCU na busca da melhoria da qualidade das a??es de promo??o ? sa?de da mulher, contribuindo no planejamento de interven??es futuras que possam reduzir a mortalidade causada por esta doen?a no munic?pio de Natal/RN