Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

INTRODUCTION: Alcohol consumption is one of themain risk factors. To assess the preconditions for the establishmentof public policies aimed at reducing alcohol consumption inArgentina, three aims were set: a) to characterize the demandand supply of alcoholic beverages; b) to evaluate the regulatoryframework regarding advertising, promotion and sponsorshipcontrol policies, and television advertising; c) to define which modelsof attributable disease burden and cost-effectiveness of interventionscould be applicable. METHODS: Data from the National HouseholdExpenditure Survey 2004/5 and 2012/3 and from the EuromonitorInternational database were analyzed. The regulatory framework,and television advertisements were examined. The literature onmodels of disease burden and cost-effectiveness of interventionswas reviewed. RESULTS: The consumption of alcoholic beveragesdid not change significantly between 2004/5 and 2012/3, and theindustry is highly concentrated. The regulation framework foradvertising is lax; more than half of the TV ads are broadcastedduring daytime, exposing minors and thus, violating internationalagreements. There are three main approaches to epidemiologicaland economic modeling that could be applicable. CONCLUSIONS:Economic, legal and epidemiological aspects useful to promotea public agenda aimed at reducing alcohol consumption inArgentina were characterized.  

INTRODUCTION: Breast cancer (BC) and colorectal cancer (CRC) both present a high burden of disease in Argentina. Hence, studying the epidemiology of these tumors constitutes a public health priority. The objective of this study was to describe the prevalence of family history of BC and CRC and to estimate the incidence of these tumors in adults aged between 35 and 74 years from two cities in Argentina: Bariloche and Marcos Paz. METHODS: As part of the prospective population-based cohort CESCAS I (Study of detection and monitoring of cardiovascular disease and risk factors in the Southern Cone of Latin America), individual information on family history of BC and CRC was collected from a representative sample of the cities of Bariloche and Marcos Paz. Cancer cases were investigated using supporting medical documentation. RESULTS: During 2016- 2017, information from 3245 participants was obtained. Family history of CRC was reported by 8.4% of the population, and 15.2% of women reported a family history of BC. The annual incidence for the 2011-2017 period was 55.2/100 000 women aged 35 to 74 years (95%CI: 22.8-133.7) for BC and 38.5/100 000 adults aged 35 to 74 years (95%CI: 15.3-96.8) for CRC.CONCLUSIONS: Besides guaranteeing universal access to screening programs, it is important to evaluate family history of cancer to identify patients with increased risk, who require specific early detection and surveillance algorithms.

INTRODUCTION: In Argentina since 1998, dengue outbreaks occurred every year except 2001 and 2005 in different areas, in 15 jurisdictions, with identification of the 4 serotypes. The objective of this study was to identify populations at higher risk of developing severe forms of the disease as an input for the possible introduction of a prevention strategy. METHODS: A descriptive, retrospective study was conducted of confirmed indigenous dengue cases from official publications, SNVS notifications and information provided by the provincial epidemiological areas. A stratification of the risk of severe dengue at department level was developed for the period 1998-2018. RESULTS: Five criteria were defined for the stratification of risks: registry of autochthonous cases in at least 2 of the last 5 years, registration of 2 or more serotypes causing 10% or more of the cases each, cumulative incidence greater than 500 cases per 100 thousand inhabitants, cumulative incidence greater than 5 cases per thousand under 15 years old and registration of severe cases or deaths. We obtained 60 departments with 1 criterion, 19 with 2, 8 with 3, 4 with 4, 1 with 5 and 129 did not complete the criteria. DISCUSSION: Only 13 departments added 3 criteria or more, result of the predominance of DENV-1, the low incidence in children under 15 years and the low number of serious and fatal cases. The stratification of population risk with systematic registration criteria is aimed at obtaining a tool for assessing dengue scenarios that may occur in the future

INTRODUCTION: Health inequalities are preventable. Breast cancer (BC) and cervical cancer (CC) are the most frequent in women. The objective of this study was to visualize inequalities in health through mortality by BC and CC in Argentina from 2001 to 2016. METHODS: An ecological study was performed. The population was composed of people who died from BC and CC in Argentina from 2001 to 2016. The sources used were: mortality database of the Statistics Direction, National Survey of Risk Factors 2013, and Census 2001 and 2010. Rates were adjusted. The unsatisfied basic needs (UBN) index was used. The relative index of inequality (RII) and concentration index were calculated. Joinpoint regression models were analyzed as well as their annual percentage change (APC), using Joinpoint Regression Program 4.1.0 and Epidat 4. RESULTS: The RII for BC had a downward trend. The APC for the period was -1% per year (p<0.05). According to the concentration curve, there was an approximation to the diagonal of equality in 2016 (concentration of deaths in provinces with lower index of UBN). The trend of RII for CC mortality was not significant, there was also an approximation to the diagonal of equality between 2001 and 2016 (deaths concentrated in provinceswith higher index of UBN). CONCLUSIONS: BC mortality inequality decreased between 2001 and 2016. Regarding CC mortality, inequality did not change significant

Lymphedema is an accumulation of lymph and abnormal fibro-fatty tissue in the limbs. Its most common origin, in Argentina, is the treatment of breast cancer. Management includes multiple interventions, ranging from non-invasive therapies to specific surgical techniques. The objective of this report was to evaluate the efficacy and safety of interventions aimed at the management of lymphoedema by reviewing the available scientific evidence, in order to guide the decision making of coverage. A bibliographic search was carried out and the PRISMA comparison list was used for the evaluation of systematic reviews. In case of discrepancies, a third reviewer was consulted. 141 works were recovered through the different search strategies, 45 were evaluated by summary or full text. Finally, 10 systematic reviews were included. The evidence for the evaluated interventions was of low confidence, mainly due to the presence of studies with a small number of patients, comparators other than usual management, heterogeneity in the interventions and limited follow-up times.

INTRODUCTION: In Argentina, agriculture requires large quantities of agrochemicals, which have different degrees of toxicity. In general terms, there are currently not enough researches addressing practices of agrochemical use by rural workers and family farmers. The objective was to describe and understand how rural workers and family farmers use and handle agrochemicals, especially focusing on the potential health risks. METHODS: A multiple case study with a qualitative approach was performed in rural areas of the provinces of Buenos Aires, Corrientes, Formosa, Misiones and Santiago del Estero. A total of 78 interviews with extension workers, agents of the health system, family farmers and rural workers were conducted, and then transcribed and analyzed. RESULTS: Agrochemicals are bought, stored and used in an insecure way in most cases, which leads to serious health risks. This is a complex social problem, encompassing individual practices as well as institutional and contextual factors. CONCLUSIONS: Intersectoral actions are required to address the incidence of agrochemical poisoning in rural workers and family farmers

Introduction: Crossdressers, transsexuals and transgenders (trans) are part of the sexual minorities. They have been victims of stigmatization, discrimination and violence since childhood, which often leads to marginalization. Considering this, it is necessary to have public policies that provide them the conditions for the exercise of citizenship. The present paper presents the results of an integrative review on the access of trans people to primary health care (PHC). Methods: Data collection performed in December 2017 on the MEDLINE, SciELO and LILACS platforms, using the descriptors in association: transsexual, transgender or transvestite, access and primary care, basic care or health. The studies should be published as of 2007 and available for free. Results: Of the 578 studies found (including replicates), 06 were selected from Brazil, USA and South Africa. Five of them used qualitative methodology and one is a systematic review. Access to PHC by trans people encounters multidimensional barriers. There are political, socioeconomic, organizational, technical and symbolic obstacles, but the technical barriers are the most impacting to access. Conclusion: In order to ensure equal access, free of prejudice and discrimination, and care based on empathy and compassion, it is necessary to include the theme of sexual and gender diversity in the training of health professionals in undergraduate, postgraduate and, in the permanent education of those involved in the care of transgender people. PHC, when asserting its attributes, shows itself as the ideal setting for the longitudinal care of these people.

Objectives: To increase the health student´s understanding regarding social dynamics that leads to marginalization, its clinical features and existing public policies, discussing their role about the change of the exposed reality. Methods: A descriptive study has been made about the type experience report, having as main focus the Extension Program “Health and Social Marginalization: suppressing curricular failures” from a University of Curitiba. The annual program was presented with monthly meetings to discuss the themes: the meaning of health and the influence of the social marginalization, health of the afro descendants, indigenous, LGB and Transsexual populations, sex workers, homeless and mental health. In places organized by medical students with teacher’s supervision, the guests, belonging to the populations under discussion or involved in public policy, demonstrated their visions and sufferings getting involved with the audience through history fragments, experience reports and difficulties descriptions and perspectives within medicine. Results: The places presented great adhesion of students from several courses, there were surprised reactions and confirmation that they never had contact with this subjects in class. Most reported elucidation in these questions and the possibility of clinical application of the content to humanize their health care practices. Conclusion: The inclusion of the theme of Marginalized Populations in the health courses programs is necessary to encourage discussions that can make significant changes in the trained physician profile, following the competencies defined in the DCNs and now in the integral care offered to patients.

Introduction: The home visit allows the health professional to break the disease-centered model, turning to an individual-centered approach. However, there is a great deficiency in the organization and management of these, which often makes it more difficult to prioritize these patients. Objective: To present the experience of a team when using a new risk evaluation and classification tool that aims to optimize the management of the home visits schedule. Methods: This is an report of the experience of a family health team, in a peripheric neighborhood of a capital city in the northeast of Brazil, that applied this tool with patients who applied this tool to home visiting patients in the period between June and November 2017. Results: The data collected were analyzed and it was possible to classify the patients regarding risk and vulnerability. This tool favored the strengthening and structuring of the registration, planning, evaluation and monitoring of the visits made in the territory. In addition, its easy application and reproducibility in different primary care settings should be emphasized. Conclusion: The use of appropriate instruments allows the identification of patients at risk and vulnerability, besides organizing the agenda, identifying people’s needs, monitoring chronic diseases, proposing strategies, and planning for future interventions.

Despite important progress in public health in Brazil, maternal deaths from unsafe abortion remain a continuous challenge. Because it is a prevailing condition in the population, a woman who seeks health care for abortion-related issues must find in the primary care facility a safe doorway and an open space for dialogue. Considering that Brazil’s legal context is one of the most restrictive in the world in relation to abortion, this text presents ideas on how the family physician can act in dealing with a situation of unwanted pregnancy, based on the experience of other countries and considering the primary care attributes and the medical ethics code. Finally, the experience of the Legal Abortion Forum in Rio Grande do Sul is reported, in order to share concrete actions aimed at the qualification of care for women who seek an abortion that is granted by law. In conclusion, in our country, a first step to acquire more significant progress on the right to abortion is to enforce the law that guarantees its fulfillment in specific situations. Moreover, the engagement of primary care professionals in harm reduction seems to be a key strategy to prevent unsafe abortion and, consequently, to reduce maternal mortality.