PERCORRENDO CAMINHOS: ITINERÁRIO TERAPÊUTICO DE MULHERES USUÁRIAS DE ÁLCOOL E/OU OUTRAS DROGAS DURANTE CICLO GRAVÍDICO-PUERPERAL

Pregnancy, childbirth and postpartum care is provided in accordance with gestational risk factors, such as use of alcohol and/or other drugs by pregnant women. The objective of this study was to trace the therapeutic itinerary of pregnant women who use alcohol and/or other drugs in the health network of a city in the Mid-North of the state of Paraná. This is a qualitative, exploratory study conducted through individual interviews. Firstly, the therapeutic itineraries were built, then the speeches were analyzed in accordance with Bardin and discussed with the aid of current literature. Regarding the therapeutic itinerary, the interviewees accessed primary care, high-risk prenatal care, and hospital services. The results identified two categories: Considerations on the use of alcohol and drugs during pregnancy, and Strengths and weaknesses of the healthcare network’s points of attention. From the statements, probable biological and social implications of using psychoactive substances during pregnancy emerged, such as complications during gestation, fetal alterations, and loss of legal rights over children. As for the points of attention, the importance of multidisciplinarity and the role of nursing were highlighted. On the other hand, the network’s disarticulation and professionals’ inability, represented by inappropriate comments and lack of guidance, appear as weakness. It was concluded that it is necessary to provide comprehensive follow-up to pregnant and postpartum women who use alcohol and drugs, with the articulation of the healthcare network and professionals free from judgment to provide a care that meets their biopsychosocial demands.

Perceptions and Attitudes Towards COVID-19 Vaccination Amongst Pregnant and Postpartum Individuals

Introduction: This study aims to characterize attitudes towards COVID-19 vaccination and to evaluate factors associated with vaccine uptake amongst pregnant individuals. Methods: An anonymous survey was distributed to a convenience sample of pregnant individuals receiving prenatal care at two large urban academic hospitals in a single healthcare network in Massachusetts. Individual demographic variables were included in the survey along with questions assessing attitudes towards COVID-19 and vaccination in pregnancy. Results: Of 477 respondents, 233 (49.3%) had received or were scheduled to receive a COVID-19 vaccine. Age, White race, non-Hispanic/LatinX ethnicity, working from home, and typical receipt of the influenza vaccine were associated with COVID-19 vaccination. 276 respondents (58.4%) reported that their provider recommended the COVID-19 vaccine in pregnancy; these participants were more likely to have received a vaccine (OR 5.82, 95% confidence interval [CI] 3.68-9.26). Vaccinated individuals were less likely to be worried about the effects of the vaccine on themselves (OR 0.18, 95% CI 0.12-0.27) or their developing babies (OR 0.17, 95% CI 0.11-0.26). Unvaccinated individuals were less likely to report that it is easy to schedule a COVID-19 vaccine (OR 0.56, 95% CI 0.34-0.93), to travel to receive a vaccine (OR 0.19, 95% CI 0.10-0.36), and to miss work to receive a vaccine (OR 0.30, 95% CI 0.18-0.48). Conclusions: Strategies are needed to improve patient education regarding vaccine side effects and safety in pregnancy and to change policy to make it feasible for pregnant patients to schedule and miss work without loss of pay to get vaccinated.

Relations between cycling and healthcare network and the case of Curitiba

Resumo Nesse momento da pandemia da Covid-19, quando surge a necessidade de distanciamento físico, a bicicleta afirma-se como modo alternativo vantajoso. Este artigo dispõe sobre a associação entre ciclismo e saúde através de um índice proposto para avaliar essa relação, o Índice de Mobilidade Cicloviária em relação à rede de Saúde (IMCS). A fundamentação teórica expõe as qualidades do modo cicloviário e as premissas que devem envolver seu planejamento. Como um estudo de caso, o sistema cicloviário de Curitiba e sua relação com as Unidades Básicas de Saúde são avaliados pelo IMCS, em seu estado atual e conforme o plano existente. Os resultados evidenciam que Curitiba negligencia a ciclomobilidade, com o sistema de saúde local praticamente inacessível pela malha cicloviária.

Prescription Patterns for Empagliflozin among Adults with Diabetes Mellitus in Dhaka, Bangladesh

Objective: To evaluate the prescribing pattern of empagliflozin with respect to other concomitant prescribed drugs in a diabetic patient. Methods: The present research study was conducted in Dhaka from May 2021 to July 2021 at National Healthcare Network (NHN), Dhaka (Jurain, Uttara and Mirpur Branch). A total of 139 were included in this study by following a simple random procedure. Results: According to the research criterion, 198 prescriptions were collected and 139 were assessed for the study. 78 (56.12%) were male and 72 (51.8%) belonged to the age group 30-64 years, and 67 (48.2%) were in the age group of 65-79 years. 57 (41%) had normal weight, followed by 33 (23.74%) who were overweight, and 49 (35.25%) patients were obese. Approximately 73 (52.52%) of prescriptions prescribed empagliflozin alone, whereas 76 (54.68%) of prescriptions prescribed the combination of empagliflozin and metformin. Among 202 co-prescribed anti-diabetic preparations other than empagliflozin (either monotherapy or combination therapy), 142 (70.30%) were oral hypoglycemic and 60 (29.70%) were insulin preparations. Apart from anti-diabetics, 396 medications were prescribed in this study, including anti-hypertensives (n=47;11.87%) and lipid-lowering drugs (n=43;10.86%). The number of protein pump inhibitors (PPIs) and nutritional supplements were 106 (26.77%) and 84 (21.21%) prescriptions respectively. Conclusion: Empagliflozin is one of the most often recommended anti-diabetic medications in Bangladesh to treat diabetes with or without cardiovascular and obesity-related complications. Other drug classes are prescribed as well, with no apparent contradictions.