Typical and atypical pattern of pulmonary sarcoidosis at high-resolution CT: relation to clinical evolution and therapeutic procedures.

AIM: This study was done to evaluate the importance of high-resolution CT (HRCT) in defining pattern and extent of disease and establishing the clinical and therapeutic pathway in sarcoidosis. MATERIALS AND METHODS: A retrospective analysis of 56 patients with pulmonary involvement of sarcoidosis was performed. Two groups were identified: 39 patients exhibiting a typical HRCT pattern and 17 patients with an atypical pattern. Inclusion criteria were the presence of radiological documentation (HRCT) of disease, clinical and radiological follow-up of 1 year and the beginning of any therapy within 1 month from the diagnosis. RESULTS: Among subjects not receiving therapy, the comparison between the two groups showed that the radiological findings remained stable in subjects with a typical pattern, while they worsened in more than 70% of cases with atypical appearance. Therapy was more effective in patients with a typical pattern. Recurrences occurred in both groups, but more often in patients with a typical pattern. One patient not receiving treatment experienced clinical worsening. Re-evaluation of HRCT within 1 year revealed no correlation between clinical deterioration and radiological changes. CONCLUSIONS: The findings of this study suggest that persistence of the inflammatory process rather than the radiological pattern at onset is a prognostic factor for recurrence.

Multiplicadores reflexivos: uma experiência do Instituto Familiae junto ao Grupo de Assistência em Transtornos Alimentares (GRATA) do HC-FMRP-USP / Reflecting practitioners program: an experience of together Institute Familiae to the Grupo de Assistência em Transtornos Alimentares (GRATA) of HC-FMRP-USP

Este artigo objetiva descrever o trabalho Multiplicadores Reflexivos desenvolvido junto ao GRATA (Grupo de Assistência em Transtornos Alimentares) do HC-FMRP-USP, pelo Instituto Familiae. O referido trabalho buscou ôcuidar dos cuidadoresõ, ou seja, da equipe interdisciplinar do GRATA, através do desenvolvimento da capacidade reflexiva, da apropriação de recursos próprios, do favorecimento da construção de histórias alternativas e da capacidade de resolver situaçães descritas como problemáticas, por estes profissionais. Foram realizados treze encontros mensais, entre o Familiae e o GRATA. As mudanças descritas pelos participantes ocorreram com a realização de atendimentos interdisciplinares em dupla e com o desenvolvimento da capacidade de construir lugares mais confortáveis, tanto na equipe como na relação profissional - usuário - família. Esta tríade passou a ser vista pela equipe em termos de seus recursos e competências, abandonando, assim, posturas baseadas nas ôfalhasõ e ôfaltasõ. Desta forma, relaçães horizontais puderam ser privilegiadas ao invés de relaçães hierarquizadas.

This article describes the “Reflecting Practitioners Program” developed by Instituto Familiae at GRATA (Grupo de Assistência em Transtornos Alimentares) placed at the ClinicalHospital of the Faculty of Medicine of Ribeirão Preto – University of São Paulo (HC-FMRP-USP). The aim of this program was “to take care of the caretakers” - the GRATA interdisciplinary team - through the development of their reflecting ability, the appropriation of their own resources and the support on constructing alternative histories and on solving situations defined by them asproblematic. Thirteen monthly meeting had been carried out among Familiae members and GRATA interdisciplinary team. The changes described by the participants had occurred throughsessions developed with interdisciplinary pairs and through the development of their capacity toconstruct more comfortable positions - as members of the team and in the relationship among professional/client/ family. This triad became to be seen by the team through its resources andabilities, instead of its “flaws” and “lacks”. As a result, horizontal relationships could be privilegedinstead of hierarchical ones