Análisis de los recursos defensivos y manejo de la muerte en grupos religiosos protestantes / Analysis of defensive resources and of coping with death in protestant religious groups / Análise dos recursos defensivos e manejo da morte emgrupos religiosos protestantes

Este trabajo buscó comprender y analizar las percepciones sobre la muerte y la finitud en grupos religiosos protestantes. Participaron 10 voluntarios autodenominados cristianos protestantes, con edades de los 18 a los 55 años. Se realizó entrevistas semiestructuradas con preguntas sobre el tema "muerte" y se aplicó el Cuestionario Desiderativo (CD), todo eso en línea, por medio de llamadas de video. Se analizó los datos según la teoría propuesta por Nijamkim y Braude. Los resultados indicaron que los mecanismos de defesa instrumentales de todos los participantes tenían fallas, y que la religión influjo en su elección de símbolos y racionalizaciones. Además, el CD mostró matices y conflictos, pues los discursos conscientes (entrevista semiestructurada), que no indicaron medo de la muerte y de la finitud, mientras los resultados del CD (respuestas inconscientes) indicaron el opuesto, mostrando inseguridad, ambivalencia y miedo de la muerteAU.

This work aimed to understand and analyze the perceptions about death and finitude in protestant religious groups. The participants were 10 volunteers, self-described as protestant Christians, from 18 to 55 years old. Semistructuredinterviews were carried out with questions about the topic "death", and the Desiderative Questionnaire (DQ) was also applied, both completely online, through videocalls. The results were analyzed according with the theoretical recommendations by Nijamkim and Braude and suggest that the instrumental defense mechanisms of all participants have shortcomings. They showed that their anxiety strongly interferes when it comes to the proximity of death and that their religion influences their choices of symbols and rationalizations. Furthermore, the DQ showed the nuances and conflicts in the conscious discourses (semistructured interview), as it indicated no fear of death and finitude, while the DQ results (unconscious responses) indicated the opposite, showing insecurities, ambivalence, and fear of deathAU.

O presente trabalho objetivou compreender e analisar as percepções sobre a morte e finitude em grupos religiosos protestantes.Participaram 10 voluntários autodenominados cristãos protestantes, com idades entre 18 e 55 anos. Foram realizadas entrevistas semiestruturadas com perguntas envolvendo a temática "morte" e aplicado o Questionário Desiderativo (QD),de forma totalmente on-line, por videochamada. A análise dos resultados seguiu a proposta teórica de Nijamkim e Braude.Os resultadosapontam que todos os participantes apresentaram falhas nos mecanismos de defesa instrumentais; eles demonstram possuir interferência intensa da ansiedade mediante a iminência da morte e demonstram influência da religião em suas escolhas de símbolos e nas racionalizações trazidas. Além disso, o QD revelou as nuances e conflitos presentes entre os discursos conscientes (entrevista semiestruturada), por trazerem a ausência do medo da morte e finitude, sendo que os resultados do QD (respostas inconscientes) apontam o oposto, uma vez que é percebido inseguranças, ambivalência e temor diante da morteAU.

Urticária crônica exacerbada por anti-inflamatórios não esteroidais e resposta aos antileucotrienos / Nonsteroidal anti-inflammatory drug-exacerbated chronic urticaria and response to antileukotrienes

Introdução: Pacientes com urticária crônica espontânea (UCE) frequentemente exacerbam com o uso de anti-inflamatórios não esteroidais (AINEs), que são medicamentos que inibem a ciclooxigenase 1 (COX-1) e levam a um desvio para produção de leucotrienos. Os antileucotrienos seriam uma opção terapêutica para aqueles que não respondam aos anti-histamínicos (AH1). Objetivo: O objetivo deste estudo foi avaliar a eficácia dos antileucotrienos nos pacientes com UCE exacerbada ou não pelos AINEs que não responderam apenas aos AH1. Método: Estudo retrospectivo com análise de prontuários eletrônicos de pacientes com UCE em seguimento ambulatorial. Todos os pacientes foram interrogados sobre a história de exacerbação ou não da UCE por AINEs. Além dos AH1, o montelucaste foi introduzido para todos os pacientes, em algum momento do acompanhamento. Foram avaliadas a resposta ao antileucotrieno e a presença da associação desta resposta à história de exacerbação com AINE. Resultados: Sessenta e dois pacientes participaram do estudo. A média de idade foi de 48,4 anos, sendo 82,3% do sexo feminino. Destes, 35 pacientes (56,5%) referiam piora da urticária com uso de AINEs, e, destes, 77,1% responderam ao antileucotrieno associado ao AH1. Dentre os 27 pacientes que não apresentavam UCE exacerbada por AINE, 48,1% obtiveram boa resposta ao uso de antileucotrieno associado ao AH1. Conclusão: A resposta ao antileucotrieno foi superior e estatisticamente significante (p = 0,031) no grupo de pacientes com UCE exacerbada por AINE. Portanto, a associação dos antileucotrienos aos AH1 seria uma opção eficaz e segura, sendo que essa associação se torna ainda mais relevante em pacientes que UC exacerbada por AINEs.

Introduction: Patients with chronic spontaneous urticaria (CSU) frequently show symptom exacerbation after the use of nonsteroidal anti-inflammatory drugs (NSAIDs) ­ drugs that inhibit cyclooxygenase-1 (COX-1) and affect leukotriene production. Antileukotrienes are considered a therapeutic option for patients who do not respond to antihistamines (AH1). Objective: The aim of this study was to assess the effectiveness of antileukotrienes in patients with CSU exacerbated or not by NSAIDs. Methods: In this retrospective study, the electronic charts of CSU outpatients were analyzed. All patients were inquired about history of CSU exacerbation or not by NSAIDs. In addition to AH1, treatment with montelukast was introduced to all patients at some point during follow-up. Response to antileukotriene treatment and association between treatment response and history of NSAID exacerbation were evaluated. Results: A total of 62 patients participated in the study. Mean age was 48.4 years, and 82.3% were female. Thirtyfive patients (56.5%) reported worsening of urticaria with the use of NSAIDs; 77.1% of these patients responded to antileukotriene combined with AH1. Of the 27 patients with no history of CSU exacerbation with NSAIDs, 48.1% showed a favorable response to antileukotrienes associated with AH1. Conclusion: Response to antileukotriene treatment was higher and statistically significant (p=0.031) in patients with NSAID-exacerbated CSU. Therefore, the association of antileukotrienes with AH1 could be a safe and effective treatment option, especially for patients with NSAIDexacerbated CSU.

Syphilis and HIV-1 among parturient women in Salvador, Brazil: low prevalence of syphilis and high rate of loss to follow-up in HIV-infected women

BACKGROUND: The occurrence of syphilis and HIV-1 infections during pregnancy are major risks to the fetus due to mother-to-child transmission (MTCT). OBJECTIVES: To determine peripartum seroprevalence and risk factors of syphilis and HIV-1 infection among pregnant women in Salvador, Brazil, and the rate of HIV-1 MTCT. METHODS:Cross-sectional study of pregnant women who were admitted for delivery in a reference maternity hospital between May 2008 and March 2009 was conducted. Women were screened for HIV-1 infection and syphilis, and interviewed regarding demographic, behavioral and obstetric data. Newborns to HIV-infected mothers were tested by b-DNA and DNA-PCR to detect HIV-1. RESULTS: A total 3300/8516 women were evaluated. Mean age was 25.8 ± 7.3 years. HIV-1 and syphilis seroprevalence rates were 0.84% (28/3300) and 0.51% (17/3300), respectively. HIV-1 infection was associated with: low education (p = 0.04), having a partner with known HIV infection (p < 0.0001) or with previous sexually transmitted infection (p < 0.0001), blood transfusion (p = 0.003), or accidental exposure to blood (p = 0.003). Syphilis was associated with being Caucasian (p = 0.02), having no steady partner (p = 0.02), being a housewife (p = 0.01), having an intravenous drug user (IVDU) sexual partner (p = 0.04) or a sexual partner with previous STI (p < 0.001). Higher education (p = 0.04) was protective against HIV-infection. Attending a prenatal care program was protective against syphilis (p = 0.008) and HIV-1 (p = 0.02). No case of HIV-1 MTCT was detected, but 25% of children born to HIV-infected mothers were lost to follow up. CONCLUSIONS: In Salvador, peripartum prevalence of syphilis and HIV-1 infection among pregnant women were low, and associated with classic risk factors for both infections. The great proportion of very late diagnosis of HIV infection, and the high rate of loss of follow-up among positive mothers and their infants are of high concern.