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Background: Caesarean rates are increasing in Brazil and worldwide, and there is a concern regarding the consequences of this increase for maternal and child health. Objective: This study aimed to analyse the proportions and the time trend of cesarean sections in the Health Region of Paraná State. Method: This is a time-series ecological study using data from the Information System on Live Births. The analyzes of the proportions and trends of cesarean sections were performed between 2003 and 2014, in three-year periods. Linear regression was used to analyze cesarean rate trends, with the significance level set at 5%. Results: The largest proportions of cesarean sections occurred between 2012 and 2014 (53.8% to 80.2%), except for the 1st Health Region (Paranaguá), with larger proportions between 2009 and 2011. All the regional ones presented an increasing trend in the proportion of cesarean sections (all p values < 0.05), except the 1st Health Region that remained with a steady trend (p = 0.10). The vast majority of the Health Region of Paraná State presented a higher proportion of cesarean sections than Brazil, for all three-year periods. Conclusion: The results indicate high proportions of cesarean sections in the Health Region in Paraná State and the vast majority showed an increasing trend of cesarean sections. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a chronic disease with high prevalence and low control rates. This study aimed to analyze the blood pressure control in hypertensive elderly followed up in a Family Health Unit and its associated factors. Methods: Cross-sectional study, with patient records analysis of 190 hypertensive elderly women. Patients' blood pressure was considered to be under control if lower than 140/90mmHg. For statistical analysis, we calculated the prevalence ratio and 95% confidence interval for controlled and not controled blood pressure, according to the association of some factors. Multivariate analyzes were conducted using logistic regression. Results: Of the 190 patients followed up, 108 (56.8%) had controlled blood pressure. In logistic regression analysis, the variables of being older than 70 years (p = 0.03) and reside in the area furthest from the facility (p = 0.002) were associated with uncontrolled blood pressure. Conclusion: Although the control rate in this population is high when compared with literature, measurements should be implemented to increase this rate and avoid future complications. [ABSTRACT FROM AUTHOR]

Purpose: Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is one of the most frequent symptoms associated with breast cancer survivors. The purposes of this study were to investigate the occurrence of fatigue in disease-free breast cancer survivors after treatment, to identify variables associated with fatigue, and to evaluate the impact of fatigue on health-related quality of life., Methods: A cross-sectional study was conducted on 202 consecutive women diagnosed with in-situ to Stage III breast cancer attending in outpatient facilities of two large hospitals, one year or more after diagnosis. They completed the Piper Fatigue Scale-Revised and the European Organization for Research and Treatment of Cancer QLQ-C30. Multiple logistic regression models were used to identify predictive factors associated with fatigue. EORTC QLQC-30 scores for fatigued survivors were compared to non-fatigued survivors., Results: The prevalence of fatigue reported by the breast cancer survivors was 37.6%. Multiple logistic regression analysis revealed that predictive factors for fatigue included younger age (odds ratio [OR]=2.23, 95% confidence interval [CI]=1.11-4.45, p = 0.024); presence of pain (OR = 3.87, 95% CI = 1.88-7.98, p = 0.000); dyspnea (OR = 3.72, 95% CI = 1.46-9.50, p = 0.006); insomnia (OR = 2.40, 95% CI = 1.19-4.86, p = 0.015); and nausea and vomiting (OR = 12.25, 95% CI = 1.18-126.75, p = 0.036). Fatigued women had poorer health-related quality of life than non-fatigued women in all domains., Conclusion: Our results suggest that many disease-free breast cancer survivors after treatment experienced fatigue that compromises their health-related quality of life.