Mother's Lived Experience During Repair of Long-Gap Esophageal Atresia: A Phenomenological Inquiry.

BACKGROUND: Infants born with long-gap esophageal atresia (LGEA) pose unique physiologic risks in the newborn period. Anatomic and physiologic anomalies require an extended hospitalization with procedural analgesia and sedation that impact the mother's experience of birth, maternal response, and nurturing of her infant. PURPOSE: The aim of this study was to understand the meaning of experiences that mothers of infants born with LGEA encounter in the neonatal intensive care unit while their infant undergoes esophageal repair. METHODS: A hermeneutical phenomenological design was used to guide this inquiry. Three mothers were interviewed on 3 separate occasions. The conversations were audio-recorded and transcribed verbatim. The findings were analyzed using fundamental existential lifeworld themes. RESULTS: The essence that conceptualized the study was "making connections: day-by-day." Themes that emerged are (a) the many phases; (b) the long and winding road; (c) a new me, my purpose; and (d) our new community. IMPLICATIONS FOR PRACTICE: Nurses' knowledge and understanding of maternal experiences of having an infant with LGEA will enable for increased physical closeness, optimizing time spent together to learn their infant's unique personality. Creating partnerships with mothers can enhance our understanding of their perspectives, concerns, needs, and guide interventions. IMPLICATIONS FOR RESEARCH: Further exploration of family dynamics including fathers, siblings, and contextual factors may illuminate interventions to enhance relationships and communication that may influence developmental outcomes for families of infants with LGEA.

Neonatal enteroviral sepsis/meningoencephalitis and hemophagocytic lymphohistiocytosis: diagnostic challenges.

We present the clinical course of three neonates with proven enteroviral infection and an initial clinical picture suggestive of hemophagocytic lymphohistiocytosis (HLH). After a complete workup, only one was treated for HLH. Of particular interest, the first newborn presented with hemophagocytic cells in the cerebrospinal fluid (CSF) and proved to have enteroviral meningoencephalitis but was ultimately not diagnosed with HLH. A fourth infant, who fulfilled the diagnostic criteria for HLH but did not have enteroviral infection, is included for comparison. We suggest that severe neonatal enteroviral infection and HLH are difficult to distinguish. Careful assessment is recommended, as prognosis and treatment differ between these two entities. Literature regarding neonatal enteroviral infection and HLH is reviewed, to demonstrate the continuum between the inflammation triggered by enteroviral infection and the occurrence of HLH, as well as their comparable CSF findings.

BRAF V600E-Positive Multisite Langerhans Cell Histiocytosis in a Preterm Neonate.

Hemorrhagic pustules with a "blueberry muffin" appearance accompanied by respiratory failure in a neonate present a challenging differential diagnosis that includes infections and neoplasms. We present a case of multiorgan, multisite Langerhans cell histiocytosis (LCH), positive for the oncogenic BRAF V600E mutation, in a preterm neonate. Infants with LCH pose a diagnostic challenge due to their heterogeneous presentations. This case is unusual in that the newborn presented with severe multiorgan involvement. Due to the rare incidence, wide spectrum of clinical manifestations, and high mortality rate, clinicians must maintain a high index of suspicion for LCH.

A integração mente e corpo em psicodermatologia / An integration mind and body in psychodermatology

Percebemos hoje um incremento dos estudos que envolvem a integração entre os aspectos médicos e psicológicos, ou seja, entre as questões do corpo e do psíquico. Dessa forma, esse artigo se propõe a revisar os achados teóricos relacionados à Psicodermatologia, permitindo ainda uma reflexão crítica a respeito do tema e de seus novos rumos. Sabe-se que a Psicodermatologia é o ramo que se dedica ao estudo e tratamento de problemas dermatológicos que são causados e/ou influenciados por fatores psicológicos. As ligações que existem com o sistema nervoso tornam a pele altamente sensível a emoções, independente da nossa consciência. Assim, a pele, muitas vezes, expressa os nossos sentimentos mesmo quando não estamos cientes deles. Fica-nos, então, a idéia de que ao falarmos de doenças de pele devemos considerar o ser humano como um ser integrado, no qual aspectos sociais, biológicos e psicológicos interagem constantemente.

Nowadays there has been an increase in the studies which involve the integration between medical and psychological aspects, that is, between body and psyche subjects. In this way this article aims at revising the theoretical findings related to Psychodermatology, allowing a critical reflection concerning to the subject and its possible new directions. We know that Psychodermatology is a branch which aims at the study and treatment of dermatologic problems which are caused ad/or influence by psychological factors. The links which exist with the nervous system make the skin highly sensitive to emotions regardless of our conscience. Therefore the skin, many times, expresses our feelings even when we are not aware of them. So, the idea that remains is that when we talk about skin diseases we should consider the human being integrally. Social, biological and psychological aspects are constantly interacting.

A prática do auto-exame das mamas em mulheres de uma comunidade universitária / Breast self-exam practice in women from an universitary community

Dados estatísticos atuais apontam para elevados índices de prevalência e mortalidade em mulheres acometidas pelo câncer de mama (INCA, 2004), o que poderia ser minimizado pela prática do auto-exame, visto que esta se caracteriza como elemento facilitador de diagnóstico precoce. Esta pesquisa teve como objetivo conhecer a prática do auto-exame das mamas em mulheres representantes da população da PUCRS. Para tanto foi utilizada uma abordagem mista (qualitativa e quantitativa), aplicando-se como instrumento um questionário semi-estruturado, em uma amostra de 215 mulheres. Os resultados mostraram que apenas 25 por cento das mulheres pesquisadas referem adotar a prática do auto-exame das mamas periodicamente como cuidado preventivo. O estudo também evidenciou que todas essas mulheres reconhecem a importância desta prática, porém, muitas vezes não sabem ou não lembram de realizá-la, e outras vezes a praticam de maneira inadequada (com relação à freqüência)