Awareness towards an increasing concern during pregnancy: maternal and perinatal outcomes of women with cancer.

BACKGROUND: Increased incidence of cancer in women of childbearing age and improvements on treatment for preserving fertility have led to higher frequency of pregnancy during or after cancer treatment. OBJECTIVE: This study aimed to describe maternal and perinatal outcomes associated with cancer and pregnancy and, as a secondary analysis, to compare outcomes of women with active disease and with remission before pregnancy. STUDY DESIGN: We performed a retrospective study of women followed up at a referral center owing to a history of cancer or cancer diagnosed during pregnancy. Data on sociodemographic information, obstetrical history, types of neoplasia, treatments offered, antenatal follow-up, and maternal and perinatal outcomes were retrieved from medical chart review. A descriptive analysis was performed and a comparison among women with active and nonactive disease was performed using Student t-test and chi-square test. RESULTS: A total of 66 women were included in a 5-year period. The most frequent types of cancer were breast (33%), hematologic (21%), brain (11%), cervical (9%), and ovarian (5%) cancers. There were 39 participants (59%) who had active disease and 26 who received oncological treatment during pregnancy, and 23 (34.8%) had a vaginal delivery. There were 4 women who needed intensive care unit admission postpartum. A total of 18 (29.5%) deliveries were at term, most newborns (59%) with adequate weight for gestational age and only 1 had Apgar score lower than 7 in the fifth minute of life. There was 1 stillbirth. The active invasive cancer during pregnancy group showed a higher rate of preterm birth and lower birthweight with significant statistical difference (P=.03 and P<.01, respectively). CONCLUSION: Breast cancer was the most frequent type of cancer in our cohort. Most deliveries were preterm, with adequate birthweight. Women with active cancer are more likely to have a preterm childbirth and newborns with lower birthweight.

Patients with psychoactive substance use disorders treated in a psychiatric emergency unit / Pacientes com transtornos relacionados ao uso de substâncias psicoativas atendidos em uma unidade de emergência psiquiátrica

To describe the socio demographic and clinical profile of patients with mental and behavioral disorders due to psychoactive substance (PAS) use, evaluated by the Psychiatric team of the Referenced Emergency Unit (REU) at the State University Clinical Hospital of Campinas (UNICAMP-HC). Methods and casuistic: This is a descriptive and quantitative study, which analyzed patients with mental and behavioral disorders due to PAS use, evaluated by the Psychiatricteam of the REU-HC-UNICAMP during a period of 12 months, starting on May 2010. Results: There were evaluated 350 patients with PAS related disorders, representing 23.8% of those who sought psychiatric care. Most were males and younger than other patients of the emergency unit. The main reason for seeking help was psychiatric complaint other than PAS related disorders (23.1%), followed by desire to be treated oneself/being admitted to inpatient psychiatric treatment (20.8%) and intoxication (12.5%); 38.5% had a diagnosis of multiple PAS dependence and 34.8% were diagnosed with isolated alcohol dependence; 36% had psychiatric comorbidities and, when compared to other patients, they received more medications during attendance and were less directed to primary care units. Conclusion: There is a high rate of consultations of patients with PAS related problems in the psychiatric emergency unit. Data on the profile of the evaluated these patients can contribute to the improvement of care to this population...

Descrever o perfil sócio demográfico e clínico de pacientes com transtornos relacionados ao uso de substâncias psicoativas (SPA) atendidos pela Psiquiatria da Unidade de Emergência Referenciada (UER) do Hospital de Clínicas (HC) da UNICAMP. Métodos e casuística: Estudo descritivo e quantitativo, que avaliou os pacientes com transtornos relacionados ao uso de SPA atendidos pela Psiquiatria da UER do HC-UNICAMP no período de 12 meses a partir de maio de 2010. Resultados: Foram avaliados 350 pacientes com transtornos por uso de SPA, representando 23.8% do total dos que procuraram atendimento psiquiátrico. Maioria do sexo masculino e mais jovens do que os demais pacientes. O principal motivo de atendimento foi queixa psiquiátrica outra que não o uso de SPA (23,1%), seguido do desejo de se tratar/internar (20,8%) e intoxicação (12,5%).38,5% tinham diagnóstico de dependência de múltiplas SPA e 34,8% dependência exclusiva de álcool;36% apresentavam comorbidade psiquiátrica. Quando comparados com os demais pacientes avaliados pela Psiquiatria, receberam mais medicações no atendimento e foram menos encaminhados à atenção primária. Conclusão: Há elevada taxa de atendimento de pessoas com problemas relacionados ao uso de SPA na emergência psiquiátrica. Dados sobre o perfil dos atendidos podem contribuir para a melhoria da assistência a esta população...