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Purpose: To investigate the association of genetic polymorphisms Gln 192 Arg and Leu 55 Met of Paraoxonase 1 ( PON1 ) gene, and Arg 213 His of Sulfotransferase 1A1 ( SUT1A1 ) gene with occurrence of breast cancer among young women living in Rio de Janeiro city. Methods: This is a hospital-based case-control study including 265 women aged 18-35 years, diagnosed with breast cancer at National Cancer Institute; and 277 controls in the same age group selected among women patients and companions of three general hospitals from Rio de Janeiro public health network. Polymorphisms genotyping was performed using the PCR-RFLP technique. Results: For PON1 gene, breast cancer women had a greater chance of being homozygote for Leu 55 Met polymorphism (OR adjusted = 1.42, 95% CI= 0.67-3.00, recessive model) and a lower chance of having at least one allele of Gln 192 Arg polymorphism (OR adjusted = 0.75, 95% CI = 0.50-1.13, dominant model), but without statistical significance. Accordingly, frequency of the haplotype Met 55 /Arg 192 was lower among breast cancer women, but no statistically significant association was observed (OR adjusted = 0.85; 95% CI = 0.48-1.51). SULT1A1 His/His genotype was significantly associated with a protective effect for breast cancer (OR adjusted = 0.51, 95% CI = 0.28-0.91, recessive model). Conclusion: Arg 213 His polymorphism of SUT1A1 gene showed a protective effect against breast cancer among Brazilian young women. More studies with different designs are needed to understand the role of PON1 and SULT1A1 polymorphisms in breast cancer development in young Brazilian women.

Objective: To describe the implementation of a rapid response team in a large nonprofit hospital, indicating relevant issues for other initiatives in similar contexts, particularly in Latin America., Methods: In general terms, the intervention consisted of three major components: (1) a tool to detect aggravation of clinical conditions in general wards; (2) the structuring of a rapid response team to attend to all patients at risk; and (3) the monitoring of indicators regarding the intervention. This work employed four half-year Plan-Do-Study-Act cycles to test and adjust the intervention from January 2013 to December 2014., Results: Between 2013 and 2014, the rapid response team attended to 2,296 patients. This study showed a nonsignificant reduction in mortality from 8.3% in cycle 1 to 5.0% in cycle 4; however, death rates remained stable in cycles 3 and 4, with frequencies of 5.2% and 5.0%, respectively. Regarding patient flow and continuum of critical care, which is a premise of the rapid response system, there was a reduction in waiting time for intensive care unit beds with a decrease from 45.9% to 19.0% in the frequency of inpatients who could not be admitted immediately after indication (p < 0.001), representing improved patient flow in the hospital. In addition, an increase in the recognition of palliative care patients from 2.8% to 10.3% was noted (p = 0.005)., Conclusion: Implementing a rapid response team in contexts where there are structural restrictions, such as lack of intensive care unit beds, may be very beneficial, but a strategy of adjustment is needed.

Background: Burnout syndrome is a sociopsychological disorder which develops in response to emotional tension and occupational stress, and is triggered by continuous stressors to which workers are exposed.It comprises three domains: emotional exhaustion, depersonalization and reduced personal accomplishment., Objectives: To establish the prevalence of physical and emotional stress (burnout) among military physicians at Marcilio Dias Naval Hospital, Rio de Janeiro, Brazil., Methods: Cross-sectional, exploratory and descriptive study with quantitative approach.Data collection was performed from March through June 2016.Assessment instruments used were Maslach Burnout Inventory and a sociodemographic questionnaire., Results: Burnout was more prevalent among women (57.1%), the participants who lived with a partner (64.3%), with age under 50 years old (100.0%), income up to 15 times the equivalent of the minimum wage (78.6%), who practiced physical activity (57.1%) and no leisure activities (78.6%).Alcohol consumption and smoking behaved as significant risk factors.Prevalence was higher for the depersonalization domain (44.8%), followed by personal accomplishment (28.4%) and emotional exhaustion (6.6%)., Conclusion: The professionals at the analyzed military hospital exhibited considerable levels of burnout, especially in regard to domain depersonalization.We call the attention to the need to develop preventive programs against burnout, particularly targeting workers exposed to emotional exhaustion, to avoid the occurrence of illness.