Percursos de mulheres submetidas à cesariana no setor público de atenção à saúde / Routes of women submitted to cesariana in the public health care sector / Percursos de mujeres submetidas a la cesariana en el sector público de atención a la salud

Objetivo: explorar os itinerários de cuidados à gestação e ao parto de mulheres submetidas à cesariana no setor público de saúde e analisar os elementos dos itinerários que colaboram para este desfecho. Métodos: estudo qualitativo no qual foram analisadas 16 entrevistas com usuárias do setor público, de municípios do Rio de Janeiro, entre os anos de 2011 e 2012, com intervalo de 6 a 18 meses pós-parto. Resultados: realizar o pré-natal em serviços de saúde, fazer exames laboratoriais e ultrassonográficos são cuidados presentes nos itinerários de todas as entrevistadas, e a participação da família reforça estes cuidados. A maioria sabia qual maternidade procurar para o parto e entendia que a via seria definida por indicações médicas. Conclusão: Prevalece o cuidado à dimensão biológica da gestação e do parto, e a cesariana aparece como parte do acervo de cuidados e não como uma escolha

Objective: to explore the routes of gestation and delivery care of women undergoing cesarean sections in the public health sector and to analyze the elements of the itineraries that collaborate for this outcome. Methods: a qualitative study in which 16 interviews with public sector users from Rio de Janeiro municipalities between 2011 and 2012 were analyzed, ranging from 6 to 18 months postpartum. Results: performing prenatal care in health services, performing laboratory and ultrasound examinations are all present in the itineraries of all the interviewees, and the participation of the family reinforces these care. Most knew which maternity to look for in childbirth and understood that the pathway would be defined by medical indications. Conclusion: care for the biological dimension of gestation and delivery prevails, and cesarean delivery appears as part of the collection of care and not as a choice

Objetivo: explorar los itinerarios de cuidados a la gestación y al parto de mujeres sometidas a la cesárea en el sector público de salud y analizar los elementos de los itinerarios que colaboran para este desenlace. Métodos: estudio cualitativo. Analizadas 16 entrevistas con usuarias del sector público, de municipios de Río de Janeiro, entre los años 2011 y 2012, con intervalo de 6 a 18 meses post-parto. Resultados: realizar prenatal en servicios de salud, hacer exámenes de laboratorio y ultrasonográficos son cuidados presentes en los itinerarios de todas entrevistadas, y la participación de la familia refuerza estos cuidados. La mayoría sabía qué maternidad buscar para el parto y entendía que la vía sería definida por indicaciones médicas. Conclusión: Prevalece el cuidado a la dimensión biológica de la gestación y del parto. La cesárea aparece como parte del acervo de cuidados, no como una elección

Trichoscopic features in diagnosis of Alopecia Areata and its relation to severity of Alopecia tool [SALT] score

Objective To assess the trichoscopic features of alopecia areata, and determine correlation between the findings and the severity of alopecia tool [SALT] score

Methods A cross-sectional study was done on 67 patients in Amrita Institute, Kochi, who were clinically diagnosed with alopecia areata of scalp. Patients were examined using Heine Delta 20 Plus dermoscope

Results Yellow dots were the most common finding on trichoscopy, seen in 86.6 percent of patients. Black dots were next most common finding, seen in 68.7 percent of patients, followed by broken hair [59.7 percent], vellus hair [49.3 percent] and tapering hairs [25.4 percent]. Grey hair was seen in 11.9 percent and coiled hair in 7.5 percent patients. There was a significant relationship between vellus hair and lower SALT score. This study did not find any significant association between the other trichoscopic features of alopecia areata and clinical type or SALT score

Conclusion Scalp lesions in alopecia areata show characteristic features on trichoscopy, such as yellow dots, black dots, broken hair, vellus hair and tapering hair. Trichoscopy is a quick, easy tool in the diagnosis of alopecia and it can be a non-invasive alternative to skin biopsy