Objective: To investigate the prevalence of difficulties in adopting initial breastfeeding techniques and their association with breast disorders in postpartum women.Methods: The cross-sectional study was carried out with 276 randomly selected mother-baby pairs in rooming-in in 3 hospitals in a city of Minas Gerais State (southeast Brazil). An assessment protocol was established to evaluate the breastfeeding technique used. The association between the variables studied and breast disorders was determined by the chi-square test followed by logistic regression, with significance level set at 0.05.Results: The main factors indicating difficulties to initiate the breastfeeding techniques were inadequate attachment of the baby to the breast (25%), baby response to the contact with the breast (26.1%) and breast disorders (28.3%). Variables associated with postparturm breast disorders were: adolescent mothers (OR 3.35; 95%CI 1.51-7.44; p=0.003); maternal schooling ≤8 years (OR 2.07; 95%CI 1.01-4.23; p=0.048); and supplement provision to the newborn at the hospital (OR 2.36; 95%CI 1.40-4.92; p=0.003). Mothers working outside the household (OR 0.31; 95%CI 0.16-0.61; p=0.001) served as as protective factor on the multivariate model.Conclusions: The main difficulties in initial breastfeeding were associated with breast disorders, and the factors associated with this problem included demographic and social, variables, as well as others related to the care routine adopted by maternity hospitals.
Objectives: the present study aimed to evaluate the influence of initial difficulties in breastfeeding on duration of exclusive breastfeeding. Methods: a prospective study with follow up of nursing mothers and their babies in the first six months of age. The studied population was randomly selected among the Brazilian public health system (SUS, Portuguese acronym) users in three hospitals. The breastfeeding observation protocol was used to collect initial data, which also included socio-demographic, prenatal assistance, delivery care, the postpartum period and the newborn variables. After hospital discharge, data were collected by phone. The multiple regression model was used for statistical analysis. Results: 175 mother-baby binomials were followed. Problems with breasts during the postpartum hospital stay (p= 0.030; OR=2.38; CI95%=1.02-5.48), maternal work outside home (p=0.027; OR=2.12; CI95%=1.03-4.31) and low maternal schooling level (p=0.017; OR=2.13; CI95%=1.10-4.06) were shown to be associated with the early interruption of exclusive breastfeeding before the child has completed 6 months of age. A family income lower than one minimum wage was a protective factor (p=0.048; OR=0.42; CI95%=0.17-0.97). Conclusions: socioeconomic aspects and difficulties in breastfeeding associated with problems with the puerperal breasts stood out as factors which restrict the duration of exclusive breastfeeding.
Objetivo: Relatar caso de doença de Castleman em região axilar, que se trata de um distúrbio linfoproliferativo raro, e revisar aspectos clínicos e terapêuticos da doença, enfatizando a importância do seu diagnóstico diferencial com patologias infecciosas e neoplásicas. Relato de caso: Trata-se de paciente assintomática apresentando nódulos mamário e axilar palpáveis, considerados suspeitos à ultrassonografia, sendo submetidos à core biopsy e punção aspirativa, respectivamente, apresentando-se benignos à microscopia. Realizada, todavia, exérese do nódulo axilar devido crescimento significativo ao exame clínico e ultrassonográfico após seis meses de acompanhamento, sendo o diagnóstico de doença de Castleman concluído após estudos histopatológico e imuno-histoquímico. Considerações finais: O diagnóstico da referida doença, ainda que raro, deve ser sempre aventado diante de desordens linfoproliferativas, devido às semelhanças clínicas e radiológicas com variadas doenças infecciosas e malignas. A paciente apresentava a doença localizada, para a qual a exérese da lesão, fornece subsídio diagnóstico e representa o tratamento curativo.
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