Posterior reversible encephalopathy syndrome: A rare entity.

Posterior reversible encephalopathy syndrome(PRES) is a proposed reversible cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, focal neurological signs and a diagnostic magnetic resonance image showing multiple hyperintense signal in cortical and subcortical white matter. We report a case of 25 year female who presented 2 days postdelivery with posterior reversible encephalopathy syndrome. Early diagnosis with MRI showing bilateral parietal and occipital hyperintensities and treatment with manitol, antiepileptics and supportive measure, the syndrome was fully reversible. Clinicians as well as radiologists should be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent neurological deficits.

As vivências de mulheres no cuidado materno / How women experience maternal care

Estudo exploratório e descritivo com abordagem qualitativa que teve como objeto as vivências de mulheres acerca do cuidado materno no espaço do Alojamento Conjunto. Teve como objetivos: descrever as vivências da mulher em relação ao cuidado materno no espaço do Alojamento Conjunto, e analisar o Alojamento Conjunto como espaço de cuidado. O estudo baseou-se nos conceitos winnicottianos de holding handling e object-presenting que implicam ser a mulher “mãe suficientemente boa” para cuidar de seu filho mesmo que no cenário hospitalar. A pesquisa foi realizada em três maternidades públicas, situadas no município de Niterói no Estado do Rio de Janeiro. O grupo de informantes constituiu-se de 18 mulheres-mães, maiores de 18 anos, que estiveram internadas nos setores de Alojamento Conjunto das referidas maternidades no primeiro semestre de 2008. Os dados foram obtidos através de entrevistas semi-estruturadas, segundo roteiro pré-estabelecido, realizadas nos domicílios e em datas determinadas, por escolha das mulheres. Para tratamento dos dados foi utilizada a análise de conteúdo proposta por Bardin (2004). A análise dos depoimentos propiciou a identificação de três categorias: “descobrindo o holding (sustentação) materno”; “identificando o handling (manejo) materno na vivência das mulheres” e “conhecendo o object- presenting”. Evidenciou-se que, embora as mulheres se mostrassem disponíveis para o cuidado materno como mães suficientemente boas, o ambiente do Alojamento Conjunto não se mostrou favorável para propiciar este cuidado. As mulheres sentiam-se abandonadas neste espaço de cuidados, não obtendo ajuda efetiva (apoio e cuidados) por parte dos profissionais que lá atuavam condição fundamental para o cuidado materno. Além disso, a ausência do acompanhante em algumas destas maternidades, deixava as mulheres ainda mais sozinhas no cuidar de seus filhos.

This exploratory, descriptive and qualitative study aimed (1) to assess how mothers considered providing their maternal care in a rooming-in environment and (2) to explore the rooming-in itself as a place of care. This study was based on the winnicottian concepts of holding, handling, and object-presenting that imply that a mother is a “good-enough mother” even in the hospital scenery. The study group was composed of 18 mothers above 18 years-old, admitted in rooming-in sectors in three public maternity hospitals in the Niterói and Rio de Janeiro municipalities in the first semester of 2008. Data were gathered through domiciliary semi-structured interviews, pre-scheduled on days chosen by the mothers themselves. The raw data were treated according to the content analysis proposed by Bardin (2004). Analysis of the mothers’ accounts allowed us to identify three categories of perceptions: finding the maternal holding; identifying the maternal handling in the women whole experience; and knowing the object-presenting. It was shown that, although the mothers committed themselves to the maternal care as good-enough mothers, the rooming-in environment did not encourage this kind of care. Women felt deserted in that place of care, and were unable to get effective help (support, care, key factors for maternal care) from professionals working there. In addition, the interdiction of escorts from family in some hospitals left the women even more solitary in the caring for their babies.

Report of Newborn deaths at Post-delivery care facilities in 2001 and 2002 / 대한법의학회지

The increase in number of nuclear families and double-income families contributed to the birth of many post-delivery care facilities, and this trend also bolstered such facilities that are not registered as a medical institution to provide post-delivery care to group of infants and new mothers. The fear of anthrax that hit America after the September 11 Attack has attributed to aggravation of the fear of virus in Korea, and the cause of infant deaths at post-delivery care facilities drew unprecedented public attention. In this context, it would be worth to note the cause of infant deaths in six cases that took place in October and November of 2001, March of 2002 at post-delivery care facilities. The age of the victims were 11 days(twin boys), 17 days(girl), 21 days(girl), 15 days(girl), 14 days(girl) and 14 days(boy). The circumstances under which those infants died were varied, but with a exception of one infant, all were presumed to have suffered from diarrhea at the facilities, and were brought to hospitals after suffering from respiratory difficulties only after care providers suspected more serious medical problems than initial thought. The first two autopsies indicated positive for rotavirus test. Autopsies of all cases except one reveal no specific findings that are noteworthy. One case shows global ischemic myocardial necrosis and pneumonia. In five cases where the amount of feeding was tracked down, the less than normal amount of feeding and the slower than normal body-weight increase were noted that lasted for several days before deaths. It is our opinion that even healthy infants in a group care facility require a higher standard of sanitation to prevent various infection and that the use of measurement that easily indicates the correlation between the amount of feeding and the body-weight increase will be helpful to prevent deaths from virus infection at group care type of post-delivery facilities.