BackgroundCervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru.Methods97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care.ResultsOf the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear.ConclusionHPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV.
Introdução: Alterações de humor, ansiedade e insônia são os transtornos mentais que mais acometem a população, sendo identificadas com maior frequência na Atenção Primária à Saúde. Para o tratamento desses transtornos, é comum a prescrição de benzodiazepínicos. Objetivo: Quantificar e estabelecer o perfil de utilização de benzodiazepínicos na população adultade duas unidades de Estratégia Saúde da Família em município do Mato Grosso. Métodos: Os dados foram coletados em prontuários que continham registro de uso de psicotrópicos, durante o ano de 2018. Resultados: Foram encontrados 164 pacientes em uso de benzodiazepínicos, dos quais, 82,9% (n=136) eram mulheres. A associação de benzodiazepínicos com outros psicotrópicos representou 66,5%, sendo a amitriptilina a mais prescrita (35,8%). Com relação ao tempo de uso foi observado que a maioria dos pacientes faz uso há mais de 6 meses (93,0%). O clonazepam foi o benzodiazepínico mais prescrito, com 70,7% (n=116) dos registros de uso, nos prontuários. A Dose Diária Definida (DDD) de clonazepam resultou em 3,19 DDD/1.000hab./dia, quando se utiliza a DDD de 8mg, e 25,57 DDD/1.000hab./dia com DDD de 1mg. Conclusão: O uso crônico de benzodiazepínicos em unidades daEstratégia Saúde da Família se mantém como problema de saúde pública, sendo que o acompanhamento adequado destes pacientes é necessário para evitar o uso indiscriminado. Além disso, intervenções que visem proporcionar melhor qualidade de vida aos usuários destes medicamentos devem ser incentivadas. Introduction: Mood swings, anxiety and insomnia are the most common mental disorders that affect the population and are most frequently identified in Primary Health Care. For the treatment of these disorders, it is common to prescribe benzodiazepines. Objective: Quantify and establish the profile of benzodiazepine use in the adult population of two units of the Family Health Strategy in a municipality in Mato Grosso. Methods: Data were collected from medical records that contained a record of psychotropic use during 2018. Results: Of the 164 patients using benzodiazepines found, 82.9% (n=136) were women. The association of benzodiazepines with other psychotropics represented 66.5%, with amitriptyline being the most prescribed (35.8%). Regarding the duration of benzodiazepine use, it was observed that most patients have been using it for more than 6 months (93.0%). Clonazepam was the most prescribed, with 70.7% (n=116) of the records of use in the medical records. The Defined Daily Dose (DDD) of clonazepam resulted in 3.19 DDD/1,000hab/day, when using DDD 8mg, and 25.57 DDD/1,000hab/day with DDD of 1mg. Conclusion: The chronic use of benzodiazepines in the Family Health Strategy Unitsremains as apublic health problem, and adequate monitoring of these patients is necessary to avoid indiscriminate use. In addition, interventions aimed at providing a better quality of life to users of these drugs should be encouraged.
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