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1.
Braz J Cardiovasc Surg ; 38(4): e20220305, 2023 07 04.
Article in English | MEDLINE | ID: mdl-37402279

ABSTRACT

INTRODUCTION: Postoperative bleeding is one of the main causes of complications in cardiovascular surgery, which highlights the importance of ensuring adequate intraoperative hemostasis, providing a better patient outcome. This study aimed to improve the prevention of postoperative bleeding in the Cardiovascular Surgery Department of the Hospital Estadual Mário Covas (Santo André, Brazil) using an adapted version of the Papworth Haemostasis Checklist to assess the impact of this standardization on bleeding rate, postoperative complications, reoperation, and mortality. METHODS: This is a non-randomized controlled clinical trial, whose non-probabilistic sample consisted of patients undergoing cardiac surgery in the abovementioned service within a two-year interval. The Papworth Haemostasis Checklist was adapted to the Brazilian laboratory parameters and the questions were translated into Portuguese. This checklist was used before the surgeon started the chest wall closure. Patients were followed up until 30 days after surgery. A P-value < 0.05 was considered statistically relevant. RESULTS: This study included 200 patients. After the checklist, a reduction in 24-hour drain output, postoperative complications, and reoperation was observed, although statistical significance was not reached. Finally, there was a significant reduction in the number of deaths (8 vs. 2; P=0.05). CONCLUSION: The use of the adapted checklist in our hospital proved to be an effective intervention to improve the prevention of postoperative bleeding, with a direct impact in the number of deaths in the study period. The reduction in deaths was possible thanks to the reduction in the bleeding rate, postoperative complications, and reoperations for bleeding.


Subject(s)
Checklist , Postoperative Hemorrhage , Humans , Postoperative Hemorrhage/prevention & control , Postoperative Hemorrhage/etiology , Postoperative Complications/prevention & control , Postoperative Complications/surgery , Reoperation , Hemostasis
2.
Case Rep Infect Dis ; 2023: 5575300, 2023.
Article in English | MEDLINE | ID: mdl-37179740

ABSTRACT

Aspergillosis is an opportunistic mycosis that generally affects the lungs. The fungus was cleared by the immune system of a healthy host. Extrapulmonary forms are very rare, and there are few reports of urinary aspergillosis. In this case report, we describe a 62-year-old woman with systemic lupus erythematosus (SLE) with complaints of fever and dysuria. The patient had recurrent episodes of urinary tract infection and several hospitalizations. A computed tomography revealed an amorphous mass in the left kidney and bladder. After partial resection of the material was referred for analysis, Aspergillus infection was suspected and confirmed by culture. Successful treatment with voriconazole was provided. Diagnosis of localized primary renal Aspergillus infection in a patient with SLE requires careful investigation due to its benign presentation and lack of associated systemic clinical features.

3.
Microbiol Resour Announc ; 12(5): e0136122, 2023 May 17.
Article in English | MEDLINE | ID: mdl-37042779

ABSTRACT

We report the draft genome sequences of four Enterococcus cecorum strains obtained from cloacal swab specimens collected from three healthy captive wild birds (two Coragyps atratus and one Parabuteo unicinctus) in Rio de Janeiro, Brazil. The genome sizes ranged from 2.38 to 2.55 Mb.

4.
PLoS Negl Trop Dis ; 17(1): e0011023, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36626374

ABSTRACT

Paracoccidioidomycosis (PCM) is a systemic mycosis endemic in Latin America, mostly in Brazil. The involvement of the gastrointestinal tract is uncommon and usually associated with the acute form. Recently, a cluster of acute PCM cases has been described in Rio de Janeiro, Brazil. We report a 42-year-old male, resident of Rio de Janeiro, presenting chronic diarrhea and abdominal pain in the past 3 years, previously diagnosed as Chron´s disease. When immunosuppressive therapy was prescribed, the patient evolved with worsening of the previous symptoms in addition to odynophagia, 20 kg-weight loss, disseminated skin lesions, diffuse lymphadenopathy and adrenal insufficiency. Histopathological and mycological examination of a skin lesion were compatible with PCM. Itraconazole was prescribed in high doses (400 mg/day). After seven months of treatment, the patient presented with acute abdominal pain which led to an emergent appendectomy, revealing the presence of the fungus. After 24 months, the patient reached clinical cure and recovered from adrenal insufficiency. We emphasize the importance of PCM as a differential diagnosis in patients with chronic diarrhea. The risk of fungal infections should be considered prior to initiating immunosupressive therapies, particularly in endemic areas.


Subject(s)
Crohn Disease , Paracoccidioides , Paracoccidioidomycosis , Male , Humans , Adult , Paracoccidioidomycosis/microbiology , Brazil/epidemiology , Immunosuppression Therapy , Abdominal Pain , Diarrhea , Diagnostic Errors
5.
Int J Dermatol ; 62(2): 260-268, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36083295

ABSTRACT

Melasma is acquired hyperpigmentation that mainly affects the face, can cause negative changes in self-esteem, and mostly affects women. Treatment is difficult, and different drugs can be used in mono or combination therapy. In this article, we present a brief overview of melasma, how to evaluate it, and a synthesis of the most commonly used topical therapies and their indications, including sunscreens, pharmacological agents, and plant extracts. Hydroquinone (4%) in monotherapy or combined with corticosteroids (dexamethasone and fluocinolone acetonide) and retinoids (tretinoin); arbutin (1%); methimazole (5%); kojic (2%), azelaic (20%), and tranexamic (5%) acids are the pharmacological agents that stand out. Correct application of these substances determines a variable improvement in melasma but often causes adverse reactions such as erythema, itching, and burning at the application site. Vitamin C can contribute to the reduction of melasma and have little or no adverse effects while sunscreens are normally used as coadjuvant therapies. In conclusion, we have compiled specific topical therapies for treating melasma and discussed those that are the most used currently. We consider it important that prescribers and researchers evaluate the best cost-benefit ratio of topical therapeutic options and develop new formulations, enabling efficacy in the treatment with safety and comfort during application, through the reduction of adverse effects.


Subject(s)
Melanosis , Sunscreening Agents , Female , Humans , Sunscreening Agents/therapeutic use , Melanosis/etiology , Tretinoin/adverse effects , Retinoids/therapeutic use , Fluocinolone Acetonide/adverse effects , Hydroquinones/therapeutic use , Treatment Outcome
6.
Rev. bras. cir. cardiovasc ; 38(4): e20220305, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1449547

ABSTRACT

ABSTRACT Introduction: Postoperative bleeding is one of the main causes of complications in cardiovascular surgery, which highlights the importance of ensuring adequate intraoperative hemostasis, providing a better patient outcome. This study aimed to improve the prevention of postoperative bleeding in the Cardiovascular Surgery Department of the Hospital Estadual Mário Covas (Santo André, Brazil) using an adapted version of the Papworth Haemostasis Checklist to assess the impact of this standardization on bleeding rate, postoperative complications, reoperation, and mortality. Methods: This is a non-randomized controlled clinical trial, whose non-probabilistic sample consisted of patients undergoing cardiac surgery in the abovementioned service within a two-year interval. The Papworth Haemostasis Checklist was adapted to the Brazilian laboratory parameters and the questions were translated into Portuguese. This checklist was used before the surgeon started the chest wall closure. Patients were followed up until 30 days after surgery. A P-value < 0.05 was considered statistically relevant. Results: This study included 200 patients. After the checklist, a reduction in 24-hour drain output, postoperative complications, and reoperation was observed, although statistical significance was not reached. Finally, there was a significant reduction in the number of deaths (8 vs. 2; P=0.05). Conclusion: The use of the adapted checklist in our hospital proved to be an effective intervention to improve the prevention of postoperative bleeding, with a direct impact in the number of deaths in the study period. The reduction in deaths was possible thanks to the reduction in the bleeding rate, postoperative complications, and reoperations for bleeding.

7.
Arq. ciências saúde UNIPAR ; 27(4): 2010-2026, 2023.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1433742

ABSTRACT

Objetivo: Analisar os casos de óbitos maternos no Estado do Maranhão no período de 2010 a 2019, uma vez que, os números de óbitos maternos são um importante indicador sobre as condições de vida da população e atenção à saúde da mulher, onde a maior parte dos casos ocorre entre mulheres em situação de vulnerabilidade. Metodolo- gia: Trata-se de estudo ecológico de série temporal, com uso de dados secundários pro- venientes de sistemas de informação em saúde. Resultados: Foi observado que, mulheres com baixo nível de escolaridade, pardas e entre a faixa etária de 20 a 29 anos foram as mais afetadas. Foi evidenciado ainda que, o ano de 2010 trouxe maior incidência de casos, onde posteriormente houve um declínio entre o espaço temporal de 2015 a 2019, vale destacar que os municípios de São Luís, Imperatriz e Caxias foram os locais com maiores proporções de casos de óbitos notificados. Considerações finais: Neste sentido, a enfermagem exerce importante papel para a diminuição do número de óbitos maternos, pois os profissionais da enfermagem têm contato direto com as gestantes durante todo o pré-natal, possibilitando a descoberta precoce de patologias nas mulheres. Destaca-se ainda que a equipe multidisciplinar que atuam na atenção primária podem realizar busca ativa e ofertar um tratamento integral as mulheres durante toda a gravidez e puerpério.


Objective: To analyze the cases of maternal deaths in the State of Maranhão from 2010 to 2019, since the numbers of maternal deaths are an important indicator of the living conditions of the population and attention to women's health, where the Most cases occur among vulnerable women. Methodology: This is an ecological time series study, using secondary data from health information systems. Results: It was observed that women with a low level of education, brown and between the ages of 20 and 29 years were the most affected. It was also evidenced that the year 2010 brought a higher incidence of cases, where later there was a decline between the time period from 2015 to 2019, it is worth noting that the municipalities of São Luís, Imperatriz and Caxias were the places with the highest proportions of cases of reported deaths. Final considerations: In this sense, nursing plays an important role in reducing the number of maternal deaths, as nursing professionals have direct contact with pregnant women throughout the prenatal period, enabling the early discovery of pathologies in women. It is also noteworthy that the multidisciplinary team working in primary care can carry out an active search and offer comprehensive treatment to women throughout pregnancy and the puerperium.


Objetivo: Analizar los casos de muertes maternas en el Estado de Maranhão de 2010 a 2019, ya que los números de muertes maternas son un indicador importante de las condiciones de vida de la población y atención a la salud de las mujeres, donde la mayoría de los casos ocurren entre mujeres vulnerables. Metodología: Se trata de un estudio de series temporales ecológicas, utilizando datos secundarios de los sistemas de información en salud. Resultados: Se observó que las mujeres con bajo nivel educativo, morenas y entre 20 y 29 años de edad fueron las más afectadas. También se evidenció que el año 2010 trajo una mayor incidencia de casos, donde luego hubo una disminución entre el período de tiempo de 2015 a 2019, se destaca que los municipios de São Luís, Imperatriz y Caxias fueron los locales con mayor proporciones de casos de muertes notificadas. Consideraciones finales: En este sentido, la enfermería juega un papel importante en la reducción del número de muertes maternas, ya que los profesionales de enfermería tienen contacto directo con las gestantes durante todo el período prenatal, posibilitando el descubrimiento precoz de patologías en la mujer. También cabe destacar que el equipo multidisciplinar que trabaja en atención primaria puede realizar una búsqueda activa y ofrecer un tratamiento integral a la mujer durante todo el embarazo y el puerperio.

8.
Microbiol Resour Announc ; 11(8): e0005722, 2022 Aug 18.
Article in English | MEDLINE | ID: mdl-35862905

ABSTRACT

We report the draft genome sequences of two commensal Enterococcus faecalis strains (designated Ca-2 and Ca-18) recovered from the cloacae of two healthy American black vultures (Coragyps atratus) in Rio de Janeiro, Brazil. The strains were found to carry a variety of antimicrobial resistance and virulence-associated genes.

9.
PLoS Negl Trop Dis ; 16(6): e0010529, 2022 06.
Article in English | MEDLINE | ID: mdl-35704666

ABSTRACT

Paracoccidioidomycosis (PCM) is one of the main endemic systemic mycoses in Latin America, usually occurring in rural areas. When PCM occurs simultaneously with underlying immunosuppressive conditions, it can present as an opportunistic disease. Between 2000 and 2017, literature reported around 200 PCM cases in people living with HIV/AIDS (PLWHA). To address research gaps on this co-infection and to study its possible temporal changes in the last decade, we performed an active co-infection case search on the HIV/AIDS and PCM cohorts from a Brazilian reference center database from 1989 to 2019. We found 20 PLWHA among 684 PCM patients (2.92%), predominantly male (70.0%) and urban workers (80.0%). The median age of patients was higher in the 2010-2019 decade (p = 0.006). The occurrence of PCM in PLWHA was lower when compared with other fungal diseases. Although 50.0% of the patients had already been diagnosed with HIV infection and presented CD4+ T cell counts greater than 200/mm3 at the time of PCM diagnosis, the suspicion of immunosuppression in the context of atypical and more severe clinical forms of PCM revealed the diagnosis of HIV infection in 35.0% of the patients. Two (10.0%) patients had an evolution compatible with immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral therapy (ART).We highlight the importance of considering a PCM diagnosis in PLWHA to prevent a late-onset treatment and progression to severe manifestations and unfavorable outcomes. In addition, HIV investigation is recommended in PCM patients, especially those with atypical and more severe clinical presentations.


Subject(s)
Coinfection , HIV Infections , Paracoccidioidomycosis , Brazil/epidemiology , Cohort Studies , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Male , Paracoccidioidomycosis/complications , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Retrospective Studies
10.
J Cosmet Dermatol ; 21(2): 729-739, 2022 Feb.
Article in English | MEDLINE | ID: mdl-33786956

ABSTRACT

BACKGROUND: The initial contact of consumers when choosing sunscreens is through the trademark, packaging, perfume, and tactile feeling of the product, outlining the popular practice of sensory science. AIMS: To describe the sensory and physical-mechanical profile of commercial sunscreens through sensory and instrumental analyses related to principal component analysis (PCA). METHODS: Seven commercial sunscreens available on the Brazilian market and with a solar protection factor (SPF) of 30 were evaluated. Physical-mechanical profiling (rheological and textural analyses) was conducted by a trained panel, followed by sensory profile characterization and descriptive analysis. The results were assessed using the Spearman correlation coefficient and PCA. RESULTS: The correlation or lack thereof of the instrumental parameters with most of the sensory aspects was demonstrated using the Spearman coefficient. PCA enabled us to identify the nature of the dissimilarities among the samples. CONCLUSIONS: The obtained results highlight the importance of descriptive sensory analysis in the research and development of sunscreens, evidencing the significance of precisely informing the products' formulation in order to be chosen by the consumer.


Subject(s)
Sun Protection Factor , Sunscreening Agents , Brazil , Humans , Rheology
11.
J Fungi (Basel) ; 9(1)2022 Dec 22.
Article in English | MEDLINE | ID: mdl-36675837

ABSTRACT

Meningeal sporotrichosis is rare and occurs predominantly in immunosuppressed individuals. This retrospective study explored clinical and laboratory characteristics, treatment, and prognosis of patients with disseminated sporotrichosis who underwent lumbar puncture (LP) at a Brazilian reference center from 1999 to 2020. Kaplan-Meier and Cox regression models were used to estimate overall survival and hazard ratios. Among 57 enrolled patients, 17 had meningitis. Fifteen (88.2%) had HIV infection, and in 6 of them, neurological manifestations occurred because of the immune reconstitution inflammatory syndrome (IRIS). The most frequent symptom was headache (88.2%). Meningeal symptoms at first LP were absent in 7/17 (41.2%) patients. Sporothrix was diagnosed in cerebrospinal fluid either by culture or by polymerase chain reaction in seven and four patients, respectively. All but one patient received prolonged courses of amphotericin B formulations, and seven received posaconazole, but relapses were frequent. Lethality among patients with meningitis was 64.7%, with a higher chance of death compared to those without meningitis (HR = 3.87; IC95% = 1.23;12.17). Meningeal sporotrichosis occurs mostly in people with HIV and can be associated with IRIS. Screening LP is indicated in patients with disseminated disease despite the absence of neurological complaints. Meningitis is associated with poor prognosis, and better treatment strategies are needed.

12.
Wounds ; 34(12): E147-E151, 2022 12.
Article in English | MEDLINE | ID: mdl-36645661

ABSTRACT

INTRODUCTION: LP is an uncommon reaction characterized by outbreaks of erythematous, painful, slightly infiltrated macules and hemorrhagic bullae that progress to ulceration that occurs in patients with Lucio leprosy and lepromatous leprosy; it can be considered a variant of type 2 or 3 reaction. Death can occur because of blood dyscrasia or sepsis. Precipitating factors include infections, drugs, and pregnancy. CASE REPORT: A 17-year-old female presented with fever, tachycardia, adynamia, extensive hyperchromic and purplish macular lesions, erythematous plaques, multiple blisters with serohematic content, and necrotic exulcerations and ulcers on the lower and upper limbs, ears, nose, palms, and soles. Past medical history included leprosy and a first trimester miscarriage. The patient was diagnosed with borderline lepromatous leprosy in reactional state (ie, LP) and MDT was restarted in association with systemic corticosteroid and pentoxifylline. Local therapy was performed with cleansing solution (0.9% sodium chloride), dressing with silver sulfadiazine ointment, and surgical debridement of the necrotic lesions. CONCLUSION: LP is a rare manifestation that may be fatal because of considerable inflammatory activity and the extent and severity of dermatologic lesions. Pregnancy is strongly associated with exacerbation of symptoms. Debridement is required to excise nonviable tissue and promote wound healing.


Subject(s)
Leprosy, Lepromatous , Leprosy, Multibacillary , Leprosy , Humans , Female , Adolescent , Leprosy, Lepromatous/drug therapy , Leprosy, Lepromatous/pathology , Erythema
13.
Rev. Psicol. Saúde ; 13(2): 111-124, abr,-jun. 2021. ilus
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1347083

ABSTRACT

Este artigo consiste em um estudo teórico sobre a complexidade dos fatores físicos, psíquicos e socioculturais implicados na vivência das mães de bebês prematuros em relação à amamentação, na unidade de terapia intensiva neonatal (UTIN). Busca-se problematizar a prática de prescrever a amamentação às gestantes e lactantes, sem levar em consideração aspectos subjetivos e inconscientes que influenciarão na adesão a esta recomendação. Os discursos dos profissionais de saúde, apoiados no excesso de informações científicas sobre a amamentação, bem como argumentos moralistas que circunscrevem este tema, não são suficientes para que se estabeleça o aleitamento materno. A amamentação vai além de um processo meramente fisiológico, exigindo da mulher condições psíquicas favoráveis para que ela possa desempenhar o papel de nutriz. Pode haver casos em que não amamentar a criança no seio traga mais benefícios à saúde mental da díade, sem que isso signifique ser a mãe menos zelosa ou cuidadosa do que as demais.


This paper consists of a theoretical study on the complexity of the physical, psychic, and sociocultural factors involved in the premature-baby-mother's breastfeeding experience, in the neonatal intensive care unit (NICU). It looks to problematize the practice of prescribing breastfeeding to pregnant and lactating women without considering subjective and unconscious aspects that will influence adherence to this recommendation. The speech of health professionals, supported by the excess of scientific information about breastfeeding, as well as moralistic arguments that circumscribe this theme, are not enough for breastfeeding to be established. Breastfeeding goes beyond a purely physiological process, requiring favorable psychic conditions from the woman so that she can play the role of a nursing mother. There may be cases in which not breastfeeding the child brings more benefits to the mental health of the dyad, without this being the mother less zealous or careful than the others.


Este artículo consiste en un estudio teórico sobre la complejidad de los factores físicos, psicológicos y socioculturales involucrados en la experiencia de las madres de bebés prematuros en relación con la lactancia materna, en la unidad de cuidados intensivos neonatales (UCIN). Buscamos problematizar la práctica de prescribir la lactancia materna a mujeres embarazadas y lactantes, sin tener en cuenta los aspectos subjetivos e inconscientes que influirán en el cumplimiento de esta recomendación. Los discursos de los profesionales de la salud, respaldados por el exceso de información científica sobre la lactancia materna, así como los argumentos moralistas que circunscriben este tema, no son suficientes para establecer la lactancia materna. La lactancia materna va más allá de un proceso puramente fisiológico, y requiere condiciones psicológicas favorables de las mujeres para que puedan desempeñar el papel de una madre lactante. Puede haber casos en los que no amamantar al niño traiga más beneficios para la salud mental de la díada, sin que esto signifique que la madre sea negligente o menos cuidadosa que las demás.

14.
J Fungi (Basel) ; 7(5)2021 Apr 28.
Article in English | MEDLINE | ID: mdl-33925084

ABSTRACT

The acute form of histoplasmosis usually occurs after the exposition of more than one individual to a common environmental source harboring Histoplasma capsulatum. Here, we present two cases of acute pulmonary histoplasmosis seen within two weeks at a reference center for infectious diseases at Rio de Janeiro, Brazil. The patients did not present a common epidemiologic history for histoplasmosis, however both presented COVID-19 before the onset of histoplasmosis symptoms. Due to the difficulties in the diagnosis of acute histoplasmosis, novel laboratory methods such as Western Blot and PCR were included in the investigation of these cases. Both patients presented negative cultures for H. capsulatum and negative urinary galactomannan. However, they presented H and M bands in the Western blot as well as a positive H. capsulatum DNA detection in sputum. These results were available approximately 36 h after sample collection, fastening the beginning of treatment of one patient. Both patients progressed well with itraconazole treatment. These cases suggest that COVID-19 may facilitate the development of acute pulmonary histoplasmosis and, therefore, clinicians must be aware of this differential diagnosis in patients from endemic areas with fever and coughing after recovery from COVID-19.

15.
J Cosmet Dermatol ; 20(4): 1066-1072, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32998180

ABSTRACT

Psoriasis is a chronic, immune-mediated disease that has a major negative impact on a patient's quality of life. Although several literature reviews indicate that skin microbiota may play an important role in the development and regulation of the immune and inflammatory response of psoriasis, few clinical studies are demonstrating the benefits of using pre-, pro- and synbiotics as a therapeutic alternative at the management of the disease. In this review, we showed the use of probiotic microorganisms that may contribute to skin homeostasis and compiled the clinical trials that demonstrate the effect of therapy with probiotics on patients with psoriasis, an important area for scientific exploration in dermatology and being the first review article to compile this information.


Subject(s)
Microbiota , Probiotics , Psoriasis , Synbiotics , Humans , Prebiotics , Probiotics/therapeutic use , Psoriasis/drug therapy , Quality of Life
16.
Estud. Interdiscip. Psicol ; 11(3): 138-152, set-dez.2020.
Article in Portuguese | LILACS | ID: biblio-1342639

ABSTRACT

Este artigo propõe um estudo teórico acerca do nascimento prematuro como um evento traumático para o bebê e a sua família, especialmente para a mãe, que também pode ser considerada uma mãe prematura. Primeiramente, falaremos sobre o trauma no contexto específico do nascimento prematuro. O trauma do nascimento será apresentado como uma falha ambiental, que está relacionada à falta de provisão dos cuidados maternos, primordiais no estágio de dependência absoluta. Depois, apontaremos possibilidades de intervenção precoce, com o objetivo de evitar a cristalização da dor e do sofrimento psíquico ocasionados pelo nascimento antecipado. O trabalho psicanalítico individual ou em grupo de escuta, bem como a literatura e o Método Canguru são mencionadas como caminhos para as mães fazerem um contorno naquilo que é real, indizível traumático, para conseguirem estabelecer um vínculo afetivo com o seu filho (AU).


This paper proposes a theoretical study on premature birth as a traumatic event for the baby and his family, especially for the mother, who can also be considered a premature mother. First, we are going to talk about trauma in the specific context of premature birth. The birth trauma will be presented as an environmental failure, which is related to the lack of provision of maternal care, essential in the stage of absolute dependence. Then, we will point out possibilities for early intervention, in order to avoid crystallization of pain and psychological suffering caused by early birth. Individual or group psychoanalytic work, as well as literature and the Kangaroo Method are mentioned as ways for mothers to outline what is real, unspeakable and traumatic, in order to establish an affective bond with their child (AU).


Este artículo propone un estudio teórico sobre el parto prematuro como un evento traumático para el bebé y su familia, especialmente para la madre, que también puede considerarse una madre prematura. Primero, hablaremos sobre el trauma en el contexto específico del parto prematuro. El trauma del nacimiento se presentará como una falla ambiental, relacionada con la falta de provisión de atención materna, esencial en la etapa de dependencia absoluta. Luego, señalaremos las posibilidades de intervención temprana, a fin de evitar la cristalización del dolor y el sufrimiento psicológico causado por el parto prematuro. El trabajo psicoanalítico individual o grupal, así como la literatura y el Método Canguro se mencionan como formas para que las madres describan lo que es traumático real e indescriptible, a fin de establecer un vínculo emocional con su hijo (AU).


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant, Premature/psychology , Premature Birth/psychology , Psychological Trauma , Psychological Distress , Mothers/psychology
17.
J Fungi (Basel) ; 6(4)2020 Nov 20.
Article in English | MEDLINE | ID: mdl-33233507

ABSTRACT

Neuroparacoccidioidomycosis (NPCM) is a rare and severe clinical presentation of paracoccidioidomycosis (PCM). We performed a retrospective cohort study at the Evandro Chagas National Institute of Infectious Diseases (INI/Fiocruz), a reference center for PCM in the state of Rio de Janeiro, Brazil. All cases of PCM admitted to the INI/Fiocruz from January 2007 to December 2019 were reviewed. Eight (3.9%) among 207 patients met the diagnostic criteria for NPCM. The mean age was 44.6 years and the male:female ratio was 7:1. All cases presented multifocal disease, 5 (62.5%) the chronic form and 3 (37.5%) the acute/subacute form. All patients presented the pseudotumoral pattern and 6 (75.0%) had multiple lesions in the cerebral hemispheres. Seizures and motor symptoms were the most frequent clinical manifestations (50.0%, each). The treatment of choice was sulfamethoxazole/trimethoprim (SMZ-TMP) and fluconazole, in association (87.5%). Most patients responded well to the treatment. Sequela and death occurred in one (12.5%) patient, each.

20.
Microbiol Resour Announc ; 8(16)2019 Apr 18.
Article in English | MEDLINE | ID: mdl-31000546

ABSTRACT

Here, we present the draft genome sequence of Enterococcus faecium strain E1298, a representative of the clonal complex 17 (CC17), identified as sequence type 1274 (ST1274) and resistant to multiple classes of antimicrobials, isolated from the cloaca of a tropical screech owl (Megascops choliba) in Rio de Janeiro, Brazil.

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