Epidemiological profile and effectiveness of immediate postpartum contraception in Brazilian women.

Purpose: To determine the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum period and compare the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC. Methods: We analyzed the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum. The data was collected by electronic medical records of postpartum women assisted at the University Hospital of São Bernardo do Campo (HMU-SBC) from January 2016 to December 2020. Also, we compared the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC by identifying women who returned for second delivery during the study period and analyzing the contraceptive method chosen in the first hospitalization. Then the pregnancies interval and the sociodemographic characteristics were analyzed according to contraceptive method type. Results: Data from 20,896 women were collected, of which 8,183 (39%) opted for Cu-IUD, 559 (2.5%) DPMA, and 10,989 (52.5%) chose not to use contraception at the time of hospital discharge. When comparing these groups, women in the DPMA were younger (26.5 ± 7.3, p < 0.05), and NCM showed women with a lower number of pregnancies (2.2 ± 1.3, p < 0.05). Subjects in the TL group (4.6%) had the higher number of pregnancies (3.8 ± 1.2, p < 0.05), and ENG group, the highest number of miscarriages (1.6 ± 1.3, p < 0.05). Of those women who returned pregnant, 5.5% belonged to the DPMA group, 6% to the NCM group, and 2.3% to the Cu-IUD. Conclusions: Women who opted for Cu-IUD insertion were younger, had more pregnancies and vaginal delivery when compared to those who did not choose a method. Of those women who returned, the minority opted for Cu-IUD compared to those that opted for DPMA or no method.

Evaluation of Maternal Fetal Outcomes of Pregnant Women and Mothers with Suspected Infection by SARS-CoV-2 Treated at the Municipal Hospital of São Bernardo do Campo (HMU-SBC), Brazil.

OBJECTIVES: The impact of Covid-19 infection on pregnancy and perinatal outcomes is not fully known. To describe the risk factors and perinatal outcome of pregnant women with suspected COVID-19 infection. METHODS: We evaluated medical records of women with suspected or confirmed SARS-CoV-2 infection who received health care services at the University Hospital of São Bernardo do Campo from March 1 to July 31, 2020, and personal, clinical, and laboratory data of these women and their newborns. RESULTS: Of the 219 women identified, 29% were asymptomatic. Considering the total population, 26% and 17% had obesity and hypertensive syndrome, respectively. Fever measured in the emergency room was the main reason for hospitalization. The presence or not of flu-like symptoms did not impact on perinatal outcomes. Pregnant women requiring hospitalization had newborns with lower birth weight (p < 0.01), shorter length (p = 0.02), and smaller head circumference (p = 0.03), and, in these cases, a higher number of cesarean section deliveries was observed. CONCLUSION: COVID-19 infection did not affect the prognosis of pregnancy and newborns. However, the worst clinical outcome, requiring hospitalization, had an impact on the anthropometric measurements of newborns.

What is already known on this subject?The SARS-CoV-2 infection is not fully undestood, specially during pregnancy and puerperae. There are conflicted information about this in the literature so far. However, it is known that respiratory infections such as influenza and SARS can develop unfavorably in pregnant women, since pregnancy changes the women's physiological condition, including altered immunity to tolerate placenta and fetus proper development.What this study adds?COVID-19 did not affect the prognosis of pregnancy and newborns in this study, but, the worst clinical outcome (hospitalization), impacted the anthropometric measurements of newborns.

Characterisation of pregnant women in a maternity hospital in Brazil who ever suffered domestic violence.

Objective: Domestic violence against women is a violation of women's rights and is a public health issue. Knowledge by all society sectors about the clinical and social characteristics of women who suffer violence is fundamental for the development of preventive actions.Methods: Data on clinical, perinatal, and socioeconomic characteristics of women attended in the municipal hospital of São Bernardo do Campo, Brazil, in 2018 and 2019 who reported ever suffering domestic violence collected and compared with to women who denied exposure to violence.Results: Marital status, schooling level, evangelical religion, drug, and tobacco use were more prevalent in women who suffered violence than those who did not. The likelihood of suffering violence was lower among pregnant women who had planned (OR 0.71), desired (OR 0.64), and accepted (0.43) pregnancy compared to those who had not planned, desired, or accepted. The average per capita income of women's neighbourhoods of origin showed an inverse correlation (R=-0.795) with the number of violence cases.Conclusion: Statistic associations suggest that the historical of having suffered from violence is more prevalent among women who planned, desired, and accepted their pregnancy, in comparison to women who denied exposure to violence. The type of religion, clinical, and social conditions of more significant vulnerability showed different levels of domestic violence.

Estresse em pacientes internados em unidade de terapia intensiva: revisão da literatura brasileira / Stress in patients admitted to intensive care unit: a review of Brazilian literature

Este estudo objetivou identificar na literatura os fatores potenciais de estresse em pacientes internados em unidade de terapia intensiva e as possíveis repercussões orgânicas a estes. Trata-se de estudo de revisão integrativa de literatura científica publicada no Brasil através das bases de dados SCIELO e LILACS, após aplicação das estratégias de seleção 10 artigos foram utilizados para esta revisão. Os resultados apontaram que são vários os agentes potenciais de estresse e que tais fatores podem causar repercussões negativas ao paciente e à sua recuperação.

Avaliação dos serviços de saúde: enfoque nos recursos humanos de um centro de terapia intensiva / Evaluation of health services-focus on human resources of an intensive care center

O estudo teve como objetivo avaliar a estrutura dos serviços de saúde por meio da avaliação dos recursos humanos de um Centro de Terapia Intensiva (CTI) de um Hospital filantrópico da zona da mata de Minas Gerais. Trata-se de uma pesquisa de caráter descritivo com abordagem qualitativa, com observação sistemática e análise documental dos instrumentos organizacionais tendo como meio de investigação o estudo de caso. O estudo utilizou como referencial teórico os conceitos de estrutura, processo e resultado propostos por Donabedian. O roteiro para coleta de dados seguiu o proposto no Programa Nacional de Avaliação dos Serviços de Saúde. Foram avaliados os seguintes aspectos: número de leitos, dimensionamento de pessoal, escala de serviço, composição profissional da equipe de saúde. Conclui-se com esta pesquisa que o CTI está de acordo com as exigências legais que obrigam as instituições a destinarem 6% dos seus leitos à CTI. Em relação ao dimensionamento de pessoal de enfermagem a Instituição não se encontra em conformidade com os padrões previstos por lei.

Mensuração das pressões intra-cuff sob as perspectivas da equipe de enfermagem / Measurement of intra-cuff pressures under the perspectives of nursing staff

Esta pesquisa teve como objetivos observar a realização das pressões do cuff; mensurar as pressões do cuff; identificar as potenciais complicações e sua repercussão nos clientes. Trata-se de uma pesquisa quase experimental, quantitativa, descritiva e com abordagem positivista. A partir da análise dos dados, foi evidenciado que as pressões iniciais estavam alteradas, expondo os pacientes às possíveis complicações relacionadas às altas pressões. Observou-se que a mensuração da pressão intra-cuff não está inserida na prática da equipe.

[Prescription, dispensing, and regulation of psychoactive anorexigenic drugs in Belo Horizonte, Minas Gerais, Brazil]. / Prescrição, dispensação e regulação do consumo de psicotrópicos anorexígenos em Belo Horizonte, Minas Gerais, Brasil.

This retrospective study in Belo Horizonte, Minas Gerais, Brazil, aimed to provide indicators on the sale and consumption of anorexigenic substances. During the first stage, 2,906 of 168,237 prescriptions received by pharmacies in 2003 were analyzed, showing low quality of prescriptions. Projected consumption in defined daily doses was 19.75 DDD/1,000 inhabitants/day in 2003. Fenproporex (59.8%) was the most widely consumed drug. One pharmacy was responsible for 39.8% of the pharmaceutical sales. During the second stage, 14,554 sales records from this "blockbuster" pharmacy were analyzed, from April to August 2005; 9.2% of sales were for anorexigenic products, 91.8% of which prescribed in association with another substance. The data suggest irrational use of anorexigenic drugs by these consumers and highlight the need for proper regulation of these products. It is important to understand both the role of pharmacies in this regulation and that of physicians in the rational use of these substances.

Prescrição, dispensação e regulação do consumo de psicotrópicos anorexígenos em Belo Horizonte, Minas Gerais, Brasil / Prescription, dispensing, and regulation of psychoactive anorexigenic drugs in Belo Horizonte, Minas Gerais, Brazil

Estudo retrospectivo, realizado na cidade de Belo Horizonte, Minas Gerais, Brasil, para avaliar indicadores de dispensação e consumo de substâncias anorexígenas. Ocorreu em duas etapas: na primeira, foram analisadas 2.906 das 168.237 notificações de receitas aviadas por estabelecimentos farmacêuticos da cidade, em 2003. Observou-se uma baixa qualidade nas notificações. O consumo projetado foi de 19,75 DDD/mil habitantes/dia. A substância mais consumida foi o fenproporex (59,8 por cento). Uma farmácia foi responsável por 39,8 por cento das dispensações. Na segunda etapa, foram analisados 14.554 registros do livro de receituário geral da farmácia que mais dispensou tais produtos, no período de abril a agosto de 2005. Os anorexígenos responderam por 9,2 por cento das manipulações e 91,8 por cento deles foram prescritos para uso concomitante com outra substância: 43 por cento com clordiazepóxido, 50,6 por cento com fluoxetina, 7,5 por cento com outro anorexígeno e 28,2 por cento com bromazepam. Os resultados observados sugerem um uso indiscriminado e irracional de anorexígenos neste município, sendo fundamental aprimorar a regulação do mercado de produtos manipulados. Para tanto, é necessário uma melhor compreensão do papel da farmácia nessa regulação e o papel dos prescritores no uso racional dessas substâncias.

This retrospective study in Belo Horizonte, Minas Gerais, Brazil, aimed to provide indicators on the sale and consumption of anorexigenic substances. During the first stage, 2,906 of 168,237 prescriptions received by pharmacies in 2003 were analyzed, showing low quality of prescriptions. Projected consumption in defined daily doses was 19.75 DDD/1,000 inhabitants/day in 2003. Fenproporex (59.8 percent) was the most widely consumed drug. One pharmacy was responsible for 39.8 percent of the pharmaceutical sales. During the second stage, 14,554 sales records from this "blockbuster" pharmacy were analyzed, from April to August 2005; 9.2 percent of sales were for anorexigenic products, 91.8 percent of which prescribed in association with another substance. The data suggest irrational use of anorexigenic drugs by these consumers and highlight the need for proper regulation of these products. It is important to understand both the role of pharmacies in this regulation and that of physicians in the rational use of these substances.

Aeromonas spp em diferentes pontos do fluxograma de beneficiamento do leite tipo A e susceptibilidade a antimicrobianos / Aeromonas spp in the line production of pasteurized type A milk and their antimicrobial susceptibility

Com o objetivo de verificar os possíveis pontos de contaminação e disseminação de bactérias do gênero Aeromonas em diferentes pontos do fluxograma de beneficiamento do leite tipo A, foram analisadas 120 amostras. Foi verificada a presença de Aeromonas spp. em 38 amostras, sendo identificadas as espécies A. sobria (40 por cento), A hydrophila (22 por cento), A. cavie (26 por cento), A. veronii (19 por cento) e A.schubertii (3 por cento). Das 37 amostras de espécies bacterianas avaliadas quanto à susceptibilidade aos antimicrobianos, foi observada múltipla resistência a drogas em 94 por cento das cepas testadas. As maiores sensibilidades foram observadas frente ao cloranfenicol, netilmicina, amicacina e gentamicina (80 por cento). A presença no leite das espécies deste gênero, comumente associadas com gastrenterites e as altas resistências observadas frente a múltiplos princípios ativos, devem ser levadas em consideração, pois podem representar um sério risco para a saúde dos consumidores, na eventual necessidade da instituição de um regime terapêutico em casos de infecção por Aeromonas spp.