ABSTRACT
A constatação da alta prevalência, em pacientes com doenças renais, de sintomas psicopatológicos, da perda da sua qualidade de vida, além das perdas reais, e da falta de informação sobre sua doença e tratamento, aponta para a necessidade da atuação dos profissionais da saúde sobre esses pontos. Através da análise crítica da interdisciplinaridade, em contraponto à multidisciplinaridade, e do alcance que o trabalho grupal apresenta, é feita uma proposta de intervenção junto aos pacientes internados em uma enfermaria de Nefrologia. A intervenção proposta é um grupo interdisciplinar rotativo aberto que trabalhe as diferentes demandas trazidas por esses pacientes. Como exemplo, é apresentado o recorte de um dos grupos realizados onde os diferentes aspectos dessa intervenção são identificados e comentados.
The high prevalence of psychopathological symptoms among renal patients, the reduced quality of life that adds to their ensuing actual losses, and the lack of information on their illness and treatment, indicates that health professionals should act on these specific points. By means of a critical analysis of interdisciplinarity vis-à-vis multidisciplinarity and taking advantage of the reach of group work, we propose an intervention, consisting of an opened rotating interdisciplinary group, offered to patients admitted to a Nephrology ward, in order to deal with their different demands. As an example, excerpts from one group session are presented, and the various aspects of the intervention are identified and commented on.
Subject(s)
Nephrology/methodsABSTRACT
OBJECTIVE: Patients with chronic kidney disease who receive early nephrology care have a better prognosis with maintenance dialysis. We aimed to determine whether early referral to a nephrologist can also improve the psychological burden of having chronic kidney disease. SUBJECTS AND METHODS: Thirty-nine patients with chronic kidney disease that required hemodialysis were studied: 19 had a $ 6-month history of nephrology care (Group1), and 20 had never received any prior nephrology care (Group2). All patients participated in a semi-structured interview that addressed their perceived knowledge and psychological aspects related to CKD and hemodialysis. Demographic and laboratory data as well as socioeconomic status were evaluated. RESULTS: In both groups, most of the patients were of low socioeconomic status. Group 1 had significantly better laboratory parameters (p<0.05). The patients' answers to the questions showed no differences between the groups: 63 percent of Group 1 and 55 percent of Group 2 reported that they had no prior knowledge about dialysis; 58 percent and 40 percent, respectively, reported that they ''don't completely understand what the doctor says''; and 74 percent and 85 percent, respectively, believed that their ''kidneys would work again''. CONCLUSION: Pre-dialysis nephrology care improves the clinical conditions of the patients with chronic kidney disease but is insufficient for minimizing other aspects of having chronic kidney disease.
Subject(s)
Female , Humans , Male , Middle Aged , Health Knowledge, Attitudes, Practice , Kidney Failure, Chronic/psychology , Patient Education as Topic/standards , Referral and Consultation/standards , Renal Dialysis/psychology , Epidemiologic Methods , Kidney Failure, Chronic/therapy , Patient Education as Topic/statistics & numerical data , Referral and Consultation/statistics & numerical data , Socioeconomic Factors , Time FactorsABSTRACT
Leptospirosis severity may be increasing, with pulmonary involvement becoming more frequent. Does this increase result from an intense immune response to leptospire? Notice that renal failure, thrombocytopenia and pulmonary complications are found during the immune phase. Thirty-five hospitalized patients with Weil's disease had 5 blood samples drawn, from the 15th day to the 12th month of symptoms, for ELISA-IgM, -IgG and -IgA specific antibody detection. According their 1st IgG titer, the patients were divided into: group 1 (n = 13) titer > 1:400 (positive) and group 2 (n = 22) titer <=1:400 (negative). Early IgG antibodies in group 1 showed high avidity which may indicate reinfection. Group 1 was older, had worse pulmonary and renal function, and fever for a longer period than group 2. Throughout the study, IgG and IgA titers remained higher in group 1. In conclusion, the severity of Weil's disease may be associated with the intensity of the humoral immune response to leptospire
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Weil Disease , Antibody Affinity , Antibody Formation , Severity of Illness Index , Immunoglobulin A , Immunoglobulin G , Enzyme-Linked Immunosorbent Assay , Chi-Square Distribution , Prospective Studies , Age Factors , Statistics, Nonparametric , Antibodies, ViralABSTRACT
A rifampicina (RFP) é um antibiótico largamente utilizado no tratamento de doenças infecciosas. O uso intermitente da droga ocasiona vários efeitos colaterais, entre eles insuficiência renal aguda (IRA). Säo relatados dois casos de pacientes portadores de hanseníase que após o uso intermitente de RFP evoluíram para IRA, anemia hemolítica e hepatotoxidade. Säo revistos os principais mecanismos causadores da IRA, sua evoluçäo e tratamento (au)