RESUMO
Raynaud's phenomenon of the nipple is a possible cause of pain and breastfeeding cessation in lactating women. However, there are still few studies on the characterization of this manifestation. Thus, we aim to develop a systematic review of the literature carried out between January 1992 and January 2024 in PubMed, Scopus, Web of Science, Virtual Health Library (VHL), and Portal de Periódicos da CAPES. Of the 438 articles, 19 met the eligibility criteria. The findings were divided by heuristic questions into two groups: "Epidemiological, pathophysiological, and clinical characterization of Raynaud's Phenomenon of the nipple" and "Treatment of Raynaud's Phenomenon of the nipple". Raynaud's phenomenon of the nipple is commonly primary, being more prevalent in the postpartum period, in women with a mean age of 32 years. The main triggers appear to be stress and temperature change. Generally, it is associated with a change in color and pain during breastfeeding. A calcium channel blocker was the most used medication with or without non-pharmacological measures.
Assuntos
Mamilos , Doença de Raynaud , Humanos , Doença de Raynaud/epidemiologia , Doença de Raynaud/fisiopatologia , Mamilos/fisiopatologia , Feminino , Aleitamento Materno , AdultoRESUMO
This retrospective cross-sectional study aimed to evaluate the factors associated with nipple lesion development in puerperae. Analyses were performed using the Poisson regression with robust variance. The level of significance was set at 5% (p < 0.05). We evaluated 1270 puerperae, among whom 193 (15.4%) presented with nipple lesions. The condition was more prevalent among the mothers who did not receive information about breastfeeding [PR, 1.69; 95% confidence interval (CI), 1.19-2.42], those who underwent cesarean delivery (PR, 1.48; 95% CI, 1.02-2.16), those who used a pacifier (prevalence ratios (PR), 2.04; 95% CI, 1.05-3.95), those who used baby formula only (PR, 1.61; 95% CI, 4.82-5.36) and those who used baby formula combined with breastfeeding (PR, 1.61; 95% CI, 1.06-2.45). A lower incidence of nipple lesions was observed among those who did not receive information on hand expression of breast milk (PR, 0.65; 95% CI, 0.46-0.93) and those who did not breastfeed in the first hour of life (PR, 0.61; 95% CI, 0.38-0.97).
Assuntos
Aleitamento Materno , Conhecimentos, Atitudes e Prática em Saúde , Mães , Mamilos/fisiopatologia , Adulto , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Incidência , Lactente , Análise Multivariada , Distribuição de Poisson , Gravidez , Estudos RetrospectivosRESUMO
The cause of pathologic nipple discharge is mainly benign lesions, but there is still a possibility of malignancy. Pathologic nipple discharge may be the only or the first symptom of breast cancer. This study aimed to investigate the clinical factors associated with lesions in patients with pathologic nipple discharge using a retrospective analysis of clinical data in 207 cases. The univariate analysis showed that age >50 years, breast lumps, or breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Discharge characteristics, duration of disease, and identification of lesions had no clear clinical significance (P > 0.05). The multivariate analysis also showed that age >50 years, breast lumps, and breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Age, breast lumps, and breast calcifications had important clinical significance in identification of benign and malignant nipple discharge.
Assuntos
Doenças Mamárias/diagnóstico , Neoplasias da Mama/diagnóstico , Mamilos/metabolismo , Mamilos/fisiopatologia , Adulto , Idoso , Calcinose/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to evaluate the clinical effectiveness of a LED phototherapy prototype apparatus in the healing of nipple trauma in breastfeeding women. BACKGROUND DATA: There is no scientific evidence of an effective treatment for nipple trauma. METHODS: The experimental group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to active LED phototherapy. The control group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to placebo LED phototherapy. Participants were treated twice a week, for a total of eight sessions. Healing of the nipple lesions was measured by a reduction in their area, and decrease in pain intensity was measured in accordance with an 11-point Pain Intensity Numerical Rating Scale and a standard 7-point patient global impression of change. RESULTS: Statistically significant reductions in measured nipple lesion area (p<0.001) were observed for both the experimental and control groups with an increase in the number of treatment sessions. A significant difference between the experimental and control groups was observed for the healing of nipple lesions (p<0.001). The pain intensity was significantly reduced only in the experimental group (p<0.001). CONCLUSIONS: Preliminary results demonstrated the prototype apparatus for LED phototherapy to be an effective tool in accelerating the healing of nipple trauma.
Assuntos
Doenças Mamárias/radioterapia , Aleitamento Materno/efeitos adversos , Dermatite/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Mamilos/lesões , Cicatrização , Administração Tópica , Adulto , Doenças Mamárias/etiologia , Doenças Mamárias/fisiopatologia , Dermatite/etiologia , Dermatite/fisiopatologia , Fármacos Dermatológicos/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Mamilos/fisiopatologia , Medição da Dor , Projetos Piloto , Medição de Risco , Índice de Gravidade de Doença , Higiene da Pele/métodos , Estatísticas não Paramétricas , Cicatrização/fisiologia , Adulto JovemRESUMO
Physicians have an essential role in promoting, protecting, and supporting breastfeeding as the ideal method of infant feeding. They are in an important position to promote breastfeeding but report difficulty in advising mothers with lactation problems. The purpose of this study is to assess knowledge about breastfeeding among primary care physicians and residents and identify potential barriers to its promotion. One hundred seventy-seven residents and physicians answered an anonymous questionnaire. The participants recognized breastfeeding benefits but 26% did not encourage exclusive breastfeeding. Mastitis, breast abscess, and the use of medications by the mother were considered contraindications to breastfeeding. Temporary breastfeeding discontinuation and bilirubin levels measurement were the preferred recommendations for the jaundiced infant. Most physicians received training in breastfeeding benefits although they report fair knowledge in myths, techniques, and contraindications. Physicians demonstrated to recognize breastfeeding benefits, but formal education is needed to eliminate barriers to breastfeeding promotion and support.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Mães/educação , Médicos de Família/educação , Abscesso/complicações , Atitude do Pessoal de Saúde , Estudos Transversais , Medicina de Família e Comunidade/educação , Feminino , Galactosemias/complicações , Pesquisas sobre Atenção à Saúde , Hepatite B/complicações , Hepatite C/complicações , Humanos , Masculino , Mastite , Mamilos/fisiopatologia , Obstetrícia/educação , Educação de Pacientes como Assunto , Pediatria/educação , Médicos de Família/psicologia , Porto Rico , Inquéritos e QuestionáriosRESUMO
La descarga por el pezón es la tercera causa de consulta en el Policlínico de Mamas de nuestra Institución. Esta sintomatología puede ser manifestación de una neoplasia. En esta revisión se comentan las causas y características semiológicas destacando que si la descarga es hemática, espontánea, acompañada de masa y en pacientes mayores de 50 años está más frecuentemente asociada a neoplasia. Finalmente se expone y comenta nuestro esquema de manejo ante las pacientes con este problema
Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Galactorreia/diagnóstico , Mamilos/fisiopatologiaRESUMO
El diagnóstico temprano del cáncer mamario es fundamental en la curación y pronóstico de las pacientes. Este se establece con base en la historia clínica, el autoexamen y la mamografía. El propósito de este trabajao fue investigar la sensibilidad la especificidad y el valor predictivo del examen físico y de la mamografía en el diagnóstico preoperatorio del cáncer mamario. En el estudio se incluyeron 523 pacientes mayores de 30 años con síntomas y signos de la glándula mamaria. Se investigó edad, características del tumor, pérdida de líquido por el pezón, signos de la areola y el pezón, y adenopatía axilar. Se practicaron 279 mamografías en dos proyecciones: craneocaudal y lateral; los diagnósticos fueron establecidos por los médicos radiólogos del Servicio de Imagenología. Todas las pacientes fueron intervenidas quirúrgicamente; 400 casos resultaron ser padecimientos benignos y en 123 se confirmó el diagnóstico de cáncer mamario mediante estudio transoperatorio. Los resultados obtenidos fueron los siguientes: El examen físico tuvo sensibilidad de 90.24 por ciento, especificidad 96.07 por ciento; valor predictivo positivo 72.8 por ciento y valor predictivo negativo 96.07 por ciento; el estudio radiológico de mamografía mostró sensibilidad del 78.57 por ciento, especificidad del 87.5 por ciento, valor predictivo positivo 69.6 por ciento y valor predictivo negativo 91.8 por ciento. Este análisis clínico muestra qué tan alto es el índice de exactitud que alcanzan el examen físico y la mamografía; también señala que ambos métodos dependen directamente tanto del adiestramiento como de la experiencia del clínico y del radiólogo
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/fisiopatologia , Neoplasias da Mama/cirurgia , Autoexame de Mama/tendências , Autoexame de Mama/estatística & dados numéricos , Exame Físico , Mamografia , Mamografia/estatística & dados numéricos , Mamilos/fisiopatologiaRESUMO
En la anamnesis se destacan algunos datos de importancia tales como edad, antecedentes ginecoobstétricos y en especial la edad al momento del primer parto y los antecedentes familiares de carcinoma mamario. Con respecto a los síntomas y signos de mayor frecuencia y envergadura, se detallan los siguientes: a) dolor cuyas principales características y posibles interpretaciones se discuten. b) tumor, considerado primero con síntoma al ser detectado por la paciente y en relación al cual se investiga el tiempode evolución, el ritmo de crecimiento, su asociación a dolor y la forma en que fue descubierto. Posteriormente se enfoca como signo cuya descripción debe consignarse tamaño, forma, límites, ubicación, consistencia y movilidad o adherencia a planos vecinos. c) descarga por el pezón abordada también desde el punto de vista anamnéstico, registrando su calidad, espontaneidad, tiempo de evolución y buscándola en el exámen físico , para precisar su tipo, número de conductos que secretan, uni o bilateralidad, facilidad con que escurre. Se describen las lesiones que con mayor frecuencia producen derrame y sus características habituales según tipo de lesión que los produce. Se discuten las posibilidades de malignidad de acuerdo al tipo de descarga. En forma breve se analizan también otros motivos de consulta tales como malformaciones, masa axilares, alteraciones cutáneas, etc. Se describe la manera correcta de realizar una anamnesis y un examen físico completo con inspección y palpación de la mama y de las regiones ganglionares accequibles. Sólo después de cumplida esta primera etapa que remata en la formulación de una hipótesis diagnóstica bien fundada, se está autorizado para solicitar exámenes complementarios adecuados, oportunos y bien seleccionados que confirmen o descarten la existencia de una patología mamaria y en el caso del carcinoma, que permitan conocer su grado de extensión