Perspectivas de pacientes sobre a vivência da psoríase: um estudo qualitativo com base na teoria Junguiana / Patients' perspectives on living with psoriasis: a qualitative study in the light of Jungian theory

RESUMO A psoríase é uma doença inflamatória e crônica de pele, de natureza benigna, sistêmica, imunomediada e não contagiosa. Pretendeu-se compreender as expressões simbólicas da psoríase e suas repercussões no processo de individuação de pacientes adultos por meio de uma pesquisa qualitativa descritivo-interpretativa. Utilizada entrevista aberta, técnica de análise de conteúdo temática e referencial teórico da Psicologia Analítica. Amostra de dezesseis participantes com psoríase em tratamento ambulatorial. Delineadas as categorias: psoríase como símbolo: surgimento, crises e remissão; rotina de tratamento: da fronteira da pele ao mundo interior; e, si-mesmo: vereda de aproximações e afastamentos. O desenvolvimento do adulto com psoríase foi compreendido pelas vivências simbólicas que apontaram para alterações na saúde integral. No entanto, reconheceu-se que as relações entre psique e corpo, apesar de conflituosas, proporcionaram aprendizados e favoreceram o processo de individuação.

ABSTRACT Psoriasis is an inflammatory and chronic skin disease, of a benign, systemic, immune-mediated and non-contagious nature. It was intended to understand the symbolic expressions of psoriasis and its repercussions on the process of individuation of adult patients through qualitative descriptive-interpretative research. Open interview, thematic content analysis technique and theoretical framework of Analytical Psychology were used. Sample of sixteen participants with psoriasis in outpatient treatment. The categories outlined: psoriasis as a symbol: onset, crises and remission; treatment routine: from the skin frontier to the inner world; and, himself: a path of approaches and distances. The development of the adult with psoriasis was understood by the symbolic experiences that pointed to changes in integral health. However, it was recognized that the relations between psyche and body, although conflicting, provided learning and favored the individuation process.

O impacto da soropositividade no vínculo mãe-bebê em gestantes diagnosticadas com HIV / The impact of seropositivity in the mother-baby bond in HIV-diagnosed pregnant women

A pesquisa objetivou estudar a construção do vínculo mãe-bebê em gestantes soropositivas, a partir da análise dos impactos do diagnóstico para essas mulheres, identificando os sentimentos envolvidos em relação ao bebê e à maternidade, e buscando compreender a vivência da construção do bebê imaginário em gestantes soropositivas. Foi realizada pesquisa transversal, do tipo qualitativa com referencial teórico psicanalítico. Participaram seis mulheres, com idade entre 19 e 36 anos e tempo de gravidez entre quatro e oito meses. Assim, de acordo com o que emergiu a partir das entrevistas, foram estabelecidas as seguintes categorias de análise para Discussão: Conhecimento do diagnóstico, Sentimentos relacionados à gravidez e Construção do vínculo com o bebê. A partir da fala das participantes e das articulações teóricas feitas à luz da psicanálise, foi possível perceber que o vínculo mãe-bebê não é necessariamente prejudicado pela presença do HIV. O desejo de que os filhos fossem saudáveis e a preocupação com relação ao futuro deles esteve presente no discurso das mulheres como importante realidade construída. Além disso, foi possível conceber a existência de um ser, por meio da imaginação e conversa com os bebês, promovendo a aposta para o lugar do sujeito.

This research aimed to study the construction of the mother-baby bond in HIV-positive pregnant women, from the analysis of the impacts of the diagnosis to these women, identifying the feelings involved about the baby and motherhood, and seeking to understand the experience of the construction of the imaginary baby in HIV-positive women. A cross-sectional research was performed in qualitative type and using psychoanalysis as the theoretical framework. Six women participated, aged between 19 and 36 years and time of pregnancy between four to eight months. According to the research aim and the material collected, the following categories were established for discussion: knowledge of the diagnosis, feelings related to pregnancy and construction of the bond with the baby. From the content of what was said by the interviewees and theoretical articulations from psychoanalysis, it was realized that mother-baby bond is not necessarily prejudiced by HIV existence. The desire for their children to be healthy and concerned about the future of them as an important constructed reality. Further, it was possible to conceive the existence of a human being through imagination and talking with babies promoting the bet to subject's place.

Isolamento de microrganismos em infecções bacterianas comunitárias e hospitalares no Centro Geral de Pediatria e compatibilidade com o tratamento / Isolated agents of nosocomial and comunnity bacterial infections in Centro Geral de Pediatria (pediatrics general center) and its treatment compatibility

Objetivo: Avaliar os agentes bacterianos isolados em culturas e sua sensibilidade aos antimicrobianos (ATB) inicialmente empregados. Métodos: Todas as crianças internadas no Centro Geral de Pediatria- FHEMIG de fevereiro/99 à julho/99 com diagnóstico de provável infecção bacteriana (segundo evidências clínicas, laboratoriais, radiológicas ou microbiológicas) ou com diagnóstico de infecção bacteriana hospitalar (segundo critérios do Centre for Disease Contral - USA (CDC) e do Ministério da Saúde) foram analisadas. Resultados: Foram analisados 336 prontuários médicos de 330 pacientes. Foram diagnosticadas 351 infecções, sendo 17 hospitalares. Prevaleceram as infecções respiratórias, sendo 153 casos de pneumonia. Os ATB mais usados foram as aminopenicilinas. A modificação da terapêutica foi feita principalmente em bases clínicas. A sensibilidade das culturas foi de 17,2%. Embora tenham sido isolados oito microorganismos resistentes, apenas quatro tiveram o ATB modificado de acordo com o antibiograma. Conclusões: O isolamento de bactérias foi menor que o desejado, mas a coleta de amostras para culturas é muito importante para o isolamento do agente causal e para o manejo clínico do paciente.

Objective: To evaluate isolated bacterial agents in cultures and their sensitiviry to the antimicrobians (ATB) used. Methods: All children admitted to the hospital from february to july/99 with probable diagnosis of bacterial infection (according to clinical, laboratorial, radiological or microbiological evidences) or with nosocomial infection (according to CDC and the Brazilian Healthy Ministry criteria) were evaluated. Results: There were 336 admissions and 330 patients. There were 351 bacterial infections, from which 17 were nosocomial infections. The respiratory tract infections prevailed, with 153 cases of pneumonia. The most used ATB were the aminnopenicilins. The therapeutical approach varied primarily according to clinical evaluation. The sensitivity of cultures was 17,2%. Even though 8 resistent microorganisms were isolated, only 4 had their ATB modified following their antibiogram. Conclusions: The number of isolated bacteria was less than expected. Nevertheless, the collection of cultures are of great importance to isolate the casual agent and to direct the clinical management.

Prevalence of tuberculin reacting and prevalence of risk factors for the development of active tuberculosis in a nursing home in Puerto Rico

A total of 91 nursing home patients were evaluated to determine the prevalence of tuberculous infection and the prevalence of risk factors for active TB in those with positive tuberculin reactions. Overall prevalence rate for positive PPD was 42.9 percent No association was found between revalence of positive PPD and time since admission to the nursing home. The most prevalent risk factors for active TB among PPD positive patients were diabetes mellitus (38.5percent), being 10 percent below ideal body weight (25.6 percent), chest X ray with fibrotic changes (13.2 percent), and carcinoma of oropharynx (5.1 percent). Twenty-one patients (53.8 percent) of patients with positive test) met criteria for prophylactic treatment with isoniazid. This study detected a high prevalence of positive PPD reactions in this nursing home population and a high prevalence of risk factors for the development of active TB in the group with positive reaction to PPD. Due to the high risk for the development of active tuberculosis in this population, aggressive screening and preventive therapy are mandatory