Prevalence, incidence, risk factors and residual risk associated with viral infections among eligible Brazilian blood donors.

Knowledge regarding the profile of eligible blood donors presenting positive results in laboratory screening is essential for reducing transfusion-transmitted human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Our study aimed to evaluate the prevalence, incidence, predictor variables and residual risk (RR) of HIV/HBV/HCV in blood bags donated in Minas Gerais, Brazil. This study analysed data retrieved from the records of a large blood bank relating to donations collected at multiple centres within the period 2012-2018, during which 1 991 120 blood bags were screened using immunoassays and nucleic acid tests (NATs). Multilevel modelling was used to investigate the association between sex, civil status and age group with HIV/HBV/HCV. RR was estimated from the incidence values (restricted to negative and positive tests within the study period) and window periods for infections. The prevalence in first time donors, incidence and RR of HCV (223.73 cases per 100 000; 54.84 per 100 000 persons-year and 1.6527 per 100 000, respectively) were higher than those of HIV (172.65 cases per 100 000; 28.25 per 100 000 persons-year and 0.8514 per 100 000) and HBV (168.17 cases per 100 000; 18.54 per 100 000 persons-year and 0.5588 per 100 000). The odds of acquiring infection were greater in male, single and older donors. Sixteen donors were identified as seronegative and NATs+ during the 7-year span of the study. Our study has clarified some spatiotemporal trends regarding HIV/HBV/HCV infections in donated blood in Brazil. The results will contribute to the formulation of directives addressed to high-risk donors.

Câncer infantil: o médico diante de notícias difíceis: uma contribuição da psicanálise / Childhood cancer: the doctor facing difficult news: a contribution from Psychoanalysis

O câncer infantil é considerado uma doença crônica associada a sofrimento e possibilidade de morte. Nesse contexto, sabe-se que a comunicação é uma das principais mediadoras do cuidado em oncologia. Comunicar notícias é algo além da mera transmissão de informações, sendo considerada uma das atividades mais delicadas da prática clínica do profissional de saúde. Diante disso, este trabalho tem o objetivo de discutir o câncer infantil e os aspectos relacionados às emoções envolvidas diante da comunicação de notícias, principalmente as más notícias, decorrentes do diagnóstico e tratamento realizado, utilizando contribuições oriundas da psicanálise. O trauma e a angústia decorrentes de situações inesperadas e difíceis podem acarretar sentimentos de impotência e desamparo, promovendo sofrimento, atitudes passivas ou fuga. Nesse sentido, os médicos, sensíveis a isso, podem adotar atitudes que minimizem tais sentimentos. Este artigo reflete ainda sobre algumas dificuldades enfrentadas pelos médicos quando se deparam comum diagnóstico grave ou um prognóstico ruim. Para além da comunicação da notícia, discute-se sobre o momento emque o profissional descobre a notícia: O que passa pela cabeça deste profissional? Quais expectativas ele lança para o paciente? Atualmente a comunicação é considerada um dispositivo fundamental no alcance de metas terapêuticas e formação do vínculo da tríade paciente, família e equipe de saúde.

Childhood cancer is considered a chronic disease associated with suffering and possible death. In this context, it isknown that communication is one of the major mediators in the oncology care. Reporting news is something beyondthe mere transmission of information, being considered one of the health professional’s most delicate aspects inthis/her clinical practice. Therefore, this paper aims at discussing childhood cancer and the aspects related to theemotions involved with the communication of news, especially bad ones, resulting from the diagnosis and treatment, using contributions originating from Psychoanalysis. The trauma and anguish due to unexpected and difficult situations can lead to feelings of powerlessness and abandonment, causing suffering, passive attitudes or escape. In this sense, doctors can adopt attitudes that minimize such feelings. This article also reflects on some of the difficulties faced by doctors when they have to deal with a serious diagnosis or a poor prognosis. Beyond the communication of news, we discuss the moment when the professional finds out the news: What goes through this professional’s mind? What expectations does he pass on to the patient? Currently, communication is considered a key device in achieving therapeutic goals and developing the bond between patient, family, and medical team.