Conhecimento das puérperas em relação ao parto humanizado e às vias de parto / Knowledge of puerperal women towards humanized delivery and modes of delivery

Objetivo: Avaliar o conhecimento das puérperas em relação ao parto humanizado e às vias de parto. Métodos: Estudo observacional transversal com 369 puérperas que realizaram seu parto em um hospital público de Curitiba, Paraná, Brasil. Aplicação de dois questionários que avaliaram características demográficas e socioeconômicas, informações sobre a gestação e o pré-natal, conhecimento de humanização e vias de parto, e atitude em relação às vias de parto. Resultados: Entre as puérperas, 72% afirmaram já terem ouvido falar no termo "parto humanizado", porém, dessas, 52,6% deram uma definição inadequada. E 48,2% obtiveram baixo conhecimento acerca das vias de parto, e 58,2% expressaram atitude positiva em relação à cesárea. Houve associação entre conhecimento prévio sobre parto humanizado e renda (p = 0,001), escolaridade (p < 0,0001), número de consultas de pré-natal (p = 0,023), busca de informações sobre as vias de parto (p < 0,0001) e preferência de parto (p = 0,011). Houve correlação do conhecimento acerca das vias de parto com renda (p = 0,044), escolaridade (p = 0,003), busca de informações sobre as vias de parto (p = 0,007) e atitude em relação à cesárea (p < 0,0001). Conclusão: Observou-se baixo conhecimento acerca das vias de parto e parto humanizado, e características como renda, escolaridade, busca por informações de forma independente e número de consultas de pré-natal possuem associação com esses conhecimentos. Um pré-natal com adequada transmissão de conhecimento relaciona-se à preferência pelo parto normal, sendo essa uma estratégia para a redução das taxas de cesárea e, consequentemente, da morbimortalidade materno-fetal.

Objective: To evaluate the knowledge of postpartum women in relation to humanized del ivery and delivery methods. Methods: Cross-sectional observational study with 369 postpartum women who delivered in a public hospital in Curitiba, Paraná, Brazil. Application of two questionnaires, which evaluated demographic and socioeconomic characteristics, information about pregnancy and prenatal care, knowledge of humanization and delivery methods, attitude towards delivery methods. Results: 72% of postpartum women said they had already heard the term "humanized childbirth", however, of these 52.6% gave an inadequate definition. 48.2% had low knowledge about delivery methods. 58.2% expressed a positive attitude towards cesarean section. There was an association between prior knowledge about humanized childbirth and income (p = 0.001), schooling (p < 0.0001), number of prenatal consultations (p = 0.023), search for information about delivery methods (p < 0 .0001), birth preference (p = 0.011). There was a correlation between knowledge about the modes of delivery with income (p = 0.044), education (p = 0.003), search for information about the modes of delivery (p = 0.007), attitude towards cesarean section (p < 0.0001). Conclusion: There was a low knowledge about the ways of delivery and humanized delivery, and characteristics such as income, education, search for information independently and the number of prenatal consultations have an association with this knowledge. A prenatal care with adequate transmission of knowledge is related to the preference for normal delivery, which is a strategy for reducing cesarean rates and, consequently, maternal-fetal morbidity and mortality.

No association between dopamine D2 receptor (DRD2) alleles and crack/cocaine dependence in Brazilians

INTRODUCTION: The causal mechanisms behind crack/cocaine use are still unknown, but genetic influences are suggested. OBJECTIVE: To investigate the relationship between the genetic polymorphism TaqI (rs1800497) in the dopamine D2 receptor (DRD2) gene and susceptibility to crack/cocaine dependence in a group of addicts to crack/cocaine and a non-addicted group. METHODS: The case group (n=515) was composed of crack/cocaine-dependent men and the control group (n=106) comprised men who were considered not dependent on crack/cocaine. The oral hygiene habits, decayed, missing, and filled teeth index, gingival index, and plaque index were evaluated. The reference single nucleotide polymorphism (rs1800497 C/T) of the DRD2 gene was genotyped by a real-time polymerase chain reaction technique. Student's t-tests for independent samples or the non-parametric Mann-Whitney test were used to compare groups regarding quantitative variables. RESULTS: The case group showed a mean time of 9.91±7.03 years of crack use, and 61.06±92.96 stones/week. The socio-demographic profile of the sample was White, single men, with basic education, blue-collar worker, smoker, and reporting alcohol use. There was a high frequency of gingival inflammation, plaque accumulation, and caries experience. For all genetic models tested, there was no significant difference in the genotypic frequency in rs1800497 of the DRD2 gene, between case and control groups (p>0.05). CONCLUSION: The genetic variant in the DRD2 did not increase the vulnerability to develop crack/cocaine dependence. The complex genetic nature of crack/cocaine dependence and a large variation of DRD2 allele frequencies, depending on the population group sampled, could be one explanation for the no association.

MEDICAL STUDENT'S MENTAL HEALTH AND THEIR ACCESS TO SUPPORT CENTERS / RETRATO DA SAÚDE MENTAL DOS ESTUDANTES DE MEDICINA E SEU ACESSO AOS CENTROS DE APOIO

Introduction: Medical education is known as a stressful environment, and it can result in a negative effect in the quality of life. For demanding many hours of stay at the university, help centers are essential to reduce the anxiety and depression in this population. Objective: To identify the mental health profile of medical students and their participation and knowledge of the support points available at the university. Methodology: Cross-sectional observational study that included 2nd, 3rd and 4th grade of medical students from a private university in Paraná. Data collection was done through an online questionnaire. Results were expressed as means ± standard deviation, absolute values, and percentages. Values of p < 0.05 were considered significant. Results: There were worse rates of mental health in women and in students with an inadequate amount of sleep. 2nd grade students know less about support services. Even with a diagnosis of mental disorders, students don't seek services in the University. Conclusion: The unequal knowledge between the grade may be influenced by the pandemic. Lack of information, stigma associated with psychological treatments and external psychological support may justify the low demand for support centers.

Introdução: O curso de medicina é conhecido como um ambiente estressante, que pode ter efeito negativo na qualidade de vida. Por exigir muitas horas de permanência na universidade, centros de auxílio são essenciais, a fim de reduzir a incidência de ansiedade e depressão nessa população. Objetivo: Identificar o perfil de saúde mental dos estudantes de medicina e sua participação e conhecimento sobre os pontos de apoio disponíveis na universidade. Metodologia: Estudo observacional transversal que incluiu alunos da 2ª, 3ª e 4ª séries de medicina de uma universidade privada paranaense. A coleta de dados foi por meio de questionário online. Os resultados foram expressos por médias ± desvio-padrão, valores absolutos e percentuais. Considerou-se significativos os valores de p < 0,05. Resultados: Evidenciou-se piores índices de saúde mental nas mulheres e em alunos com quantidade inadequada de sono. Alunos da 2ª série conhecem menos os serviços de apoio. Mesmo com diagnóstico de transtornos mentais, os alunos não buscam os serviços dentro da Universidade. Conclusão: O conhecimento desigual entre as séries pode ter influência da pandemia. Falta de informação, estigma associado aos tratamentos psicológicos e acompanhamento psicológico externo podem justificar a baixa procura pelos centros de apoio.

Whether drug detection in urine and oral fluid is similar? A systematic review.

Urine has been a biological matrix of choice for drug screening, but recent advances in technology and the introduction of commercial oral fluid assays have effectively established oral fluid as a viable alternative matrix. This systematic review aimed to evaluate the sensitivity of oral fluid in detecting some illicit drugs compared to urine, and to compare the initial and final detection times of these drugs in both fluids. The electronic search in MEDLINE, Cochrane Library, Scopus, and Web of Science was carried out covering studies published from January 2003 and June 2019, in order to find all valid studies that detected drugs in oral fluid and urine in the same patient. Studies about illicit drugs, such as tetrahydrocannabinol, cocaine, amphetamines and illicit opioids, with fluids collection at the same day, controlled drug administration during the study, reported administration interval and time of collection were favored. Out of 2598 studies identified by electronic search, 7 studies were selected for qualitative analysis. Five were clinical trials and 2 were crossover trials. In total, 74 patients aged 20-52 years underwent a diagnostic examination (4 studies with tetrahydrocannabinol, 1 with methamphetamine, and 2 with cocaine) after drug administration. Illicit drug detection in oral fluid is similar to urine but oral fluid has a strong potential for the immediate detection of recent marijuana use compared to urine. In relation to cocaine and methamphetamine, the largest drugs detection window is obtained through urine analysis. Oral fluids cannot replace urine for most of the purposes of drug testing.