Seguimento pós-natal da dilatação do trato urinário fetal: protocolo de conduta do complexo hospitalar da Universidade Federal do Ceará

Com o avançar da assistência ao pré-natal, o rastreio e a detecção de patologias que acometem o binômio mãe-feto têm crescido exponencialmente. Nesse contexto, intervenções precoces estão, cada vez mais, avançando na medicina. A hidronefrose fetal, uma das anomalias mais frequentemente identificadas, configura-se como uma alteração estrutural que merece atenção particular, visto que o acompanhamento e a intervenção precoces impactam muito na sobrevida e na qualidade de vida dos pacientes. O objetivo deste protocolo é propor uma linha de cuidado do lactente com dilatação do trato urinário e firmar condutas, a fim de unificar e facilitar o acompanhamento desses pacientes no âmbito da Maternidade-Escola Assis Chateaubriand, bem como no Ambulatório de Especialidades Pediátricas do Hospital Universitário Walter Cantídio. Trata-se de uma proposta inovadora, ainda a ser aprovado na instituição supracitada, uma vez que esse tópico é pouco discutido e ainda gera dúvidas sobre a abordagem adequada desta condição nos serviços de saúde. A metodologia utilizada se fundamentou em estudos bibliográficos sobre o assunto. Conclui‑se que a sistematização de um protocolo dessa natureza auxilia na condução mais criteriosa, evitando exames desnecessários e gerando menos ansiedade entre pais e equipes de saúde que acompanham os pacientes.

Social support in the healthcare of women submitted to breast cancer treatment

This study aimed to verify the prevalence of low social support (LSS) and associated factors in women submitted to breast cancer (BC) treatment. A cross-sectional study was carried out with 101 female residents of the municipality of Natal (Northeast Brazil), diagnosed with BC and submitted to oncological treatment. Data collection took place between July/2015 and May/2016 from medical records and individuals' interviews, and from the Medical Outcome Study-Social Support Survey. Descriptive, bivariate and multivariate statistics were carried out through Poisson's regression with robust variance and significance level 0.05. Prevalence of LSS in women with BC was 22.8% with confidence interval 14.6-39.94. Type of access to public services (p < .03), prevalence ratio (PR) 1.84 and negative self-rated health (p < .001), PR 4.47 were associated with LSS. These results were obtained after adjustments by the variables age and presence of chronic diseases. The associations established herein could have been mostly related to fragilities of the Brazilian health system, and can contribute to the planning of actions directed to the studied population.

Body Image of Women Submitted to Breast Cancer Treatment

Background: The study of body image includes the perception of women regarding the physical appearance of their own body. The objective of the present study was to verify the prevalence of body image dissatisfaction and its associated factors in women submitted to breast cancer treatment. Methods: A cross-sectional study carried out with 103 female residents of the municipality of Natal (Northeast Brazil), diagnosed with breast cancer who had undergone cancer treatment for at least 12 months prior to the study, and remained under clinical monitoring. The variable body image was measured through the validated Body Image Scale (BIS). Socioeconomic variables and clinical history were also collected through an individual interview with each participant. The Pearson’s chi-squared test (Fisher’s Exact) was utilized for bivariate analysis, calculating the prevalence ratio with 95% confidence interval. Poisson regression with robust variance was utilized for multivariate analysis. The statistical significance considered was 0.05. Results: The prevalence of body image dissatisfaction was 74.8% CI (65%-82%). Statistically significant associations were observed between body image and multi-professional follow-up (p=0.009) and return to employment after treatment (p=0.022). Conclusion: It was concluded that women who reported employment after cancer treatment presented more alterations in self-perception concerning their appearance. Patients who did not receive multi-professional follow-up reported negative body image, evidencing the need for strategies that increase and improve healthcare, aiming to meet the demands of this population.

Functional Disability in Women Submitted to Breast Cancer Treatment

The objective of the study presented herein was to verify the prevalence of functional disability and its associated factors in women submitted to breast cancer treatment. A cross-sectional study was carried out, in 101 women diagnosed with malignant breast cancer neoplasm, who underwent cancer treatment at least 12 months before the study, and remained under clinical monitoring. Functional disability was measured by the DASH instrument. Data collection included variables related to socioeconomic characteristics, life habits, health conditions, clinical tumor characteristics and therapeutic approach. Bivariate analysis was carried out by Pearson’s chi-square test or Fisher’s exact test, calculating the prevalence ratio with a 95% confidence interval. Multivariate analysis utilized Poisson’s Regression with robust variance. A statistical significance of 0.05 was considered. Prevalence of functional disability in the studied sample was 22.8% (CI95% 13.9-31.6). Functional disability was statistically significantly associated with age (p = 0.035) and access to health services (p = 0.028). It was concluded that younger patients suffered higher impact of breast cancer treatment on disability. Regarding access to health services, women that received public clinical monitoring reported higher occurrences of functional disability. This pointed towards the necessity of more organized, less bureaucratic, and effective health services in the assistance network, directed to the minimization of the impacts of cancer treatment on health and life conditions of breast cancer survivors.