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  • Is it Ethical to Offer ART in Transplant Patients? (mini review)
    Publication . Abreu Dos Santos, Filipa; Câmara, Sara; Reis, Filipa; Pestana, C; Ledo, Marta; Pinto, Paula
    Numerous medical and surgical innovations have improved transplant recipient outcomes and this improved survival has led to an increased focus on their quality of life issues. This renewed focus includes controlling fertility and breeding. However, not all reproductive-age transplant recipients are able to conceive naturally. For this women in fertility is considered a threat to their quality of life. The decision to use Assisted Reproduction Techniques (ART) to help solid organ transplant female patients become pregnant raises unique medical and ethical concerns .
  • Short and long acting reversible contraceptive
    Publication . Câmara, Sara
    Overview: The daily pill, a short-acting reversible contraceptive (SARC), is more used than long-acting reversible contraceptives (LARC) though these are highly effective, safe and less dependent on women use. It is important to identify which differences between SARC or LARC users can justify this choice.Aims: Describe and compare the two types of contraceptive methods users (age, marital status, previous history of pregnancy, level of education, age at which the method was started, level and source of knowledge, medical advice and level of satisfaction with the information received). As a secondary objective, we aimed to identify the existence of myths and misbeliefs about contraception and the reasons for choosing or discontinuation of the contraceptive method.Study Design: Observational and retrospective. Population:Women who use or had used contraception, aged 18 -50 years. Methods: A self-report and anonymous questionnaire, available in primary health care centers and hospitals. Results:In a group of 300 women, with a median of 35,6 years (18 - 50 years; s = 8,3 years), 68% (203/300) were using a contraceptive method and 28% (83/300) were no longer using it . Among these, 75% were using SARC or these corresponded to the last method used. Single women prevailed in the SARC group (p=0,002) and those with a previous pregnancy prevailed in the LARC group (p=0,002). No other statistically significant differences were identified. 86% (237/274) had a medical consultation before beginning to use a contraceptive, and 59% (139/237) were very satisfied with the information received. The control of the menstrual cycle was important for SARC users whether the using facility was important for LARC users. Conclusions:Although effective and safe,LARC where less prevalent in our study. History of previous pregnancy was the only clinically significant difference between SARC and LARC users..
  • Registo Oncológico na Região, 2018
    Publication . Camacho, Carolina; Queiroz Nunes, Carolina; Fraga, Cláudia; Santos, Filipa; Camacho, José; Barradas, Nuno; Serrão, Patrícia; Ornelas, Paula; Berenguer, Pedro; Rubina, Lara; Teixeira, Rubina; Câmara, Sara; Muller, Sara
    Introdução : Em 2018, foram identificados na RAM 1410 novos casos de doenças oncológicas. Destes, 1159 corresponderam a casos de tumores malignos que foram incluídos na análise estatística principal. A exclusão de carcinomas da pele não melanoma (tipo basocelular, espinocelular, não especificados e outros) realiza-se de modo a ser possível a comparação com outros dados estatísticos nacionais e internacionais. A taxa de incidência bruta de cancro na RAM foi de 455,2/100.000 habitantes. Os cancros mais frequentes na RAM em 2018 foram o cancro da mama, da próstata, do cólon e do recto, da cabeça e pescoço (cavidade oral, faringe, vias aéreas superiores) e do pulmão.Objetivos e Metodologia O presente relatório constitui o segundo volume do Registo Oncológico da RAM, e contém informação sobre a incidência de cancro em 2018, na Região Autónoma da Madeira. Pretende -se que a publicação de dados do registo oncológico tenha uma periodicidade anual. Objetivos: 1. Recolher dos dados inseridos na plataforma do RON (Query), referente a novos casos de Tumores Malignos na RAM no ano de 2018, de forma a estabelecer parâmetros estatísticos legíveis e de fácil interpretação. 2. Aferir dados demográficos da população alvo, caracterização clínica e biológica dos Tumores Malignos, taxas de incidência e dados de sobrevivência populacional. 3. Divulgação dos resultados obtidos a todos os profissionais de saúde da RAM e público em geral, em formato digital ou em livro para consulta. Métodos: Os dados utilizados foram recolhidos através de Query na plataforma nacional do RON, e inclui todos os novos casos diagnosticados na RAM de 01-01-2018 a 31-12-2018. A classificação topográfica e morfológica dos tumores baseou-se na terceira edição da International Classification of Diseases for Oncology (ICD-O-3). As tabelas e gráficos estão organizados segundo a nomenclatura da International Classification of Diseases, 10a edição, 1990 (ICD-10). Foram excluídos da análise principal os carcinomas basocelulares (M8090/3-M8110/3), espinocelulares (M8051/3-M8084/3, M8120/3- M8131/3) e não especificados (M8000/3 e M8010/3) da pele, para permitir a comparação dos dados de incidência com outros registos de cancro internacionais que não recolhem sistematicamente este tipo de dados. Os tumores in situ (M----/2) e MGUS (Gamapatia Monoclonal de Significado Incerto) também foram excluídos da análise principal. Na avaliação de frequências estatísticas é considerada a mediana em detrimento da média por representar uma medida estatística mais robusta com ponto de rutura de 50%, não sendo tão distorcida por valores extremos (ex. idade mediana, tempo de espera mediano, etc.). São apresentadas as taxas de incidência de cancro brutas, especificas para a idade, segundo o sexo, e padronizadas (população Europeia e Mundial). Para o cálculo foi utilizada a estimativa oficial da população residente, fornecidas pelo Direção Regional de Estatística da Madeira. Os resultados foram expressos como taxa anual por 100000 pessoas-ano. Para permitir a comparação de taxas entre populações com diferentes estruturas etárias, as taxas foram padronizadas pelo método direto, com recurso à população padrão mundial e à população padrão europeia.
  • Métodos contracetivos reversíveis de curta e longa duração
    Publication . Câmara, Sara; Abreu-dos-Santos, Filipa; Freitas, Cláudia
    ABSTRACT Overview: The daily pill, a short-acting reversible contraceptive (SARC), is more used than long-acting reversible contraceptives (LARC) though these are highly effective, safe and less dependent on women use. It is important to identify which differences between SARC or LARC users can justify this choice. Aims: Describe and compare the two types of contraceptive methods users (age, marital status, previous history of pregnancy, level of education, age at which the method was started, level and source of knowledge, medical advice and level of satisfaction with the information received). As a secondary objective, we aimed to identify the existence of myths and misbeliefs about contraception and the reasons for choosing or discontinuation of the contraceptive method. Study Design: Observational and retrospective. Population: Women who use or had used contraception, aged 18 -50 years. Methods: A self-report and anonymous questionnaire, available in primary health care centers and hospitals. Results: In a group of 300 women, with a median of 35,6 years (18 - 50 years; s = 8,3 years), 68% (203/300) were using a contraceptive method and 28% (83/300) were no longer using it . Among these, 75% were using SARC or these corresponded to the last method used. Single women prevailed in the SARC group (p=0,002) and those with a previous pregnancy prevailed in the LARC group (p=0,002). No other statistically significant differences were identified. 86% (237/274) had a medical consultation before beginning to use a contraceptive, and 59% (139/237) were very satisfied with the information received. The control of the menstrual cycle was important for SARC users whether the using facility was important for LARC users. Conclusions: Although effective and safe, LARC where less prevalent in our study. History of previous pregnancy was the only clinically significant difference between SARC and LARC users..
  • Essure* present controversies and 5 years learned lessons: a retrospective study with short and long term follow-up.
    Publication . Câmara, Sara; de Castro Coelho, Filipa; Freitas, F; Remesso, Lilia
    The risk.benefit of contraception with ESSURE* is being readressed due to na increase of reports of adverse effects with with this device. Our aim was to proceed to na interna quality evaluation and to identify opportunities for protocol improvement .We proceeded to a one-center, retrospective consecutive case series of women admitted for Essure* placement from 1 January 2012 until 31 December 2016(5 years).Results: In a total of 274 women, tecnhical difficulties were mainly unilateral, with na acute or short-term severe complications The procedure was brief, median 3.2 min, IQR 2.5-5.2 and moderately painful (median of 4 in a -0-10 scale; , IQ,3-5). At 3 months, the failure rate was 2%, with no pregnancies. etc...
  • Métodos contracetivos reversíveis de curta e longa duração - estudo observacional
    Publication . Câmara, Sara; Abreu-dos-Santos, F; Freitas, C
    Abstract:Overview: The daily pill, a short-acting reversible contraceptive (SARC), is more used than long-acting reversible contraceptives (LARC) though these are highly effective, safe and less dependent on women use. It is important to identify which differences between SARC or LARC users can justify this choice. Aims: Describe and compare the two types of contraceptive methods users (age, marital status, previous history of pregnancy, level of education, age at which the method was started, level and source of knowledge, medical advice and level of satisfaction with the information received). As a secondary objective, we aimed to identify the existence of myths and misbeliefs about contraception and the reasons for choosing or discontinuation of the contraceptive method. Study Design: Observational and retrospective. Population: Women who use or had used contraception, aged 18 -50 years. Methods: A self-report and anonymous questionnaire, available in primary health care centers and hospitals. Results: In a group of 300 women, with a median of 35,6 years (18 - 50 years; s = 8,3 years), 68% (203/300) were using a contraceptive method and 28% (83/300) were no longer using it . Among these, 75% were using SARC or these corresponded to the last method used. Single women prevailed in the SARC group (p=0,002) and those with a previous pregnancy prevailed in the LARC group (p=0,002). No other statistically significant differences were identified. 86% (237/274) had a medical consultation before beginning to use a contraceptive, and 59% (139/237) were very satisfied with the information received. The control of the menstrual cycle was important for SARC users whether the using facility was important for LARC users. Conclusions: Although effective and safe, LARC where less prevalent in our study. History of previous pregnancy was the only clinically significant difference between SARC and LARC users..