Discussão sobre a potencial aplicação da psicoterapia interpessoal em um caso de paciente com múltiplas comorbidades / Discussion on the potencial application on the interpersonal psychotherapy to a patient with multiple comorbidities

A Terapia Interpessoal (TIP) é um método de tratamento desenvolvido para o tratamento de episódios depressivos unipolares. Para esta finalidade, é uma modalidade de tratamento com eficácia comprovada em diversos estudos. Sua técnica concentra-se na abordagem de problemas interpessoais atuais, sem ignorar a importância de questões intrapsíquicas, experiências passadase fatores biológicos. Trata-se de uma terapia de curta duração, de doze a dezesseis semanas, cujo objetivo é o alívio de sintomas do humor sem a ambição de alterar aspectos da personalidade. Em função dos bons resultados obtidos pela TIP em pacientes deprimidos, adaptações da técnica original foram desenvolvidas para o tratamento de outras patologias, para as quais ainda não há evidências suficientes da eficácia do tratamento. Este artigo discute a técnica e indicações da TIP e seu potencial para o tratamento de uma paciente com múltiplas comorbidades psiquiátricas

Interpersonal Psychotherapy (IPT) is a treatment modality developed to treatunipolar major depressive episodes. A large number of studies confirm itsefficacy. Its technique focuses on current interpersonal problems and considers the intra-psychic matters, past experiences and biological factors. It consists of a brief therapy, 12 to 16 weeks long, aiming at the relief of the mood symptoms without promoting any change in the personality aspects. Due tothe positive IPT results on depressive patients, there have been adaptationsfrom its original technique to the treatment of other pathologies. Up to now, little evidence has supported these new uses of IPT. This paper discusses the IPT technique and its indications. Finally, it discusses the potential use of this therapy in the treatment of a patient whit multiple psychiatric comorbidities

Discussão sobre a potencial aplicação da psicoterapia interpessoal em um caso de paciente com múltiplas comorbidades / Discussion on the potencial application on the interpersonal psychotherapy to a patient with multiple comorbidities

A terapia interpessoal (TIP) é um método de tratamento desenvolvido para o tratamento de episódios depressivos unipolares. Para esta finalidade, é uma modalidade de tratamento com eficácia comprovada em diversos estudos. Sua técnica concentra-se na abordagem de problemas interpessoais atuais, sem ignorar a importância de questões intrapsíquicas, experiências passadase fatores biológicos. Trata-se de uma terapia de curta duração, de doze a dezesseis semanas, cujo objetivo é o alívio de sintomas do humor sem a ambição de alterar aspectos da personalidade. Em função dos bons resultados obtidos pela TIP em pacientes deprimidos, adaptações da técnica original foram desenvolvidas para o tratamento de outras patologias, para as quais ainda não há evidências suficientes da eficácia do tratamento. Este artigo discute a técnica e indicações da TIP e seu potencial para o tratamento de uma paciente com múltiplas comorbidades psiquiátricas.

Interpersonal psychotherapy (IPT) is a treatment modality developed to treat unipolar major depressive episodes. A large number of studies confirm its efficacy. Its technique focuses on current interpersonal problems and considers the intra-psychic matters, past experiences and biological factors. It consists of a brief therapy, 12 to 16 weeks long, aiming at the relief of the mood symptoms without promoting any change in the personality aspects. Due tothe positive IPT results on depressive patients, there have been adaptations from its original technique to the treatment of other pathologies. Up to now, little evidence has supported these new uses of IPT. This paper discusses the IPT technique and its indications. Finally, it discusses the potential use of this therapy in the treatment of a patient whit multiple psychiatric comorbidities.

Microscopy and polymerase chain reaction detection of Leishmania chagasi in the pleural and ascitic fluid of a patient with AIDS: Case report and review of diagnosis and therapy of visceral leishmaniasis.

Atypical visceral leishmaniasis is increasingly reported in immunocompromised patients, including patients with AIDS. A case of visceral leishmaniasis in an HIV-infected Brazilian patient with pulmonary and peritoneal involvement is reported. Histological evaluation of pleural fluid and ascites aspirate revealed macrophages with intracellular Leishmania. Polymerase chain reaction analysis was positive for Leishmania in the pleural and ascitic fluid with use of primers specific for Leishmania chagasi. In addition to classical methods for diagnosing leishmaniasis, such as microscopy and culture, polymerase chain reaction detection and identification of Leishmania species in pleural effusions and ascites are important diagnostic tools that should be considered by clinicians evaluating HIV-infected patients from endemic areas of visceral leishmaniasis. The authors review the clinical manifestations, diagnostic and therapeutic aspects of visceral leishmaniasis in immunocompetent and HIV-infected patients.

Impact of cerebral cardiopulmonary resuscitation maneuvers in a general hospital: prognostic factors and outcomes.

OBJECTIVE: To assess survival of patients undergoing cerebral cardiopulmonary resuscitation maneuvers and to identify prognostic factors for short-term survival. METHODS: Prospective study with patients undergoing cardiopulmonary resuscitation maneuvers. RESULTS: The study included 150 patients. Spontaneous circulation was re-established in 88 (58%) patients, and 42 (28%) were discharged from the hospital. The necessary number of patients treated to save 1 life in 12 months was 3.4. The presence of ventricular fibrillation or tachycardia (VF/VT) as the initial rhythm, shorter times of cardiopulmonary resuscitation maneuvers and cardiopulmonary arrest, and greater values of mean blood pressure (BP) prior to cardiopulmonary arrest were independent variables for re-establishment of spontaneous circulation and hospital discharge. The odds ratios for hospital discharge were as follows: 6.1 (95% confidence interval [CI] = 2.7-13.6), when the initial rhythm was VF/VT; 9.4 (95% CI = 4.1-21.3), when the time of cerebral cardiopulmonary resuscitation was < 15 min; 9.2 (95% CI = 3.9-21.3), when the time of cardiopulmonary arrest was < 20 min; and 5.7 (95% CI = 2.4-13.7), when BP was > 70 mmHg. CONCLUSION: The presence of VF/VT as the initial rhythm, shorter times of cerebral cardiopulmonary resuscitation and of cardiopulmonary arrest, and a greater value of BP prior to cardiopulmonary arrest were independent variables of better prognosis.

Impacto das manobras de reanimação cardiorespiratória cerebral em um hospital geral: fatores prognósticos e desfechos / Impact of cerebral cardiopulmonary resuscitation maneuvers in a general hospital: prognostic factors and outcomes

OBJECTIVE: To assess survival of patients undergoing cerebral cardiopulmonary resuscitation maneuvers and to identify prognostic factors for short-term survival. METHODS: Prospective study with patients undergoing cardiopulmonary resuscitation maneuvers. RESULTS: The study included 150 patients. Spontaneous circulation was re-established in 88 (58 percent) patients, and 42 (28 percent) were discharged from the hospital. The necessary number of patients treated to save 1 life in 12 months was 3.4. The presence of ventricular fibrillation or tachycardia (VF/VT) as the initial rhythm, shorter times of cardiopulmonary resuscitation maneuvers and cardiopulmonary arrest, and greater values of mean blood pressure (BP) prior to cardiopulmonary arrest were independent variables for re-establishment of spontaneous circulation and hospital discharge. The odds ratios for hospital discharge were as follows: 6.1 (95 percent confidence interval [CI] = 2.7-13.6), when the initial rhythm was VF/VT; 9.4 (95 percent CI = 4.1-21.3), when the time of cerebral cardiopulmonary resuscitation was < 15 min; 9.2 (95 percent CI = 3.9-21.3), when the time of cardiopulmonary arrest was < 20 min; and 5.7 (95 percent CI = 2.4-13.7), when BP was > 70 mmHg. CONCLUSION: The presence of VF/VT as the initial rhythm, shorter times of cerebral cardiopulmonary resuscitation and of cardiopulmonary arrest, and a greater value of BP prior to cardiopulmonary arrest were independent variables of better prognosis