Incertidumbre y afrontamiento en familiares de personas dependientes del alcohol: apoyo social y espiritualidad / Uncertainty and coping among relatives of alcohol dependent persons: social support and spirituality / Incerteza e enfrentamento em parentes de pessoas dependentes de álcool: apoio social e espiritualidade

Resumen Introducción: La dependencia al alcohol, considerada como una enfermedad crónica, es un detonante de incertidumbre para el familiar de la persona con dependencia, lo cual genera trastornos emocionales negativos. El apoyo social y la espiritualidad son mecanismos de afrontamiento que podrían disminuir la incertidumbre y favorecer el bienestar tanto físico, como psicológico. Objetivos: Determinar la relación y el efecto del apoyo social y la espiritualidad sobre la incertidumbre del familiar de la persona dependiente del alcohol. Métodos: Estudio descriptivo y correlacional, muestra de 135 mujeres pertenecientes a grupos Al-Anon, se utilizaron la Escala de Percepción de Incertidumbre en Padres y Miembros de la Familia (PPUS-FM) de Mishel, el cuestionario MOS-SSS de Sherbourne y Stewart y la Escala de Perspectiva Espiritual elaborada por Reed. Resultados: Se identificó un coeficiente de correlación negativo y significativo de la incertidumbre con el apoyo social (r s= -.356, p <.01) y la espiritualidad (r s= -.216, p <.05). Mediante un modelo de regresión lineal general univariado se determinó que únicamente el apoyo social influye en la disminución de la incertidumbre (β= -.280, t= -3.62, p= .001) con un coeficiente de determinación o varianza explicada del 11.5%, mientras que la espiritualidad no mostró efecto (β= -.041, t= .218, p >.05) sobre la incertidumbre. Conclusiones: El apoyo social es identificado como un mecanismo de afrontamiento efectivo que permitirá al personal de enfermería desarrollar intervenciones dirigidas a reducir la incertidumbre en familiares de personas con algún tipo de dependencia.

Abstract Introduction: Alcohol dependency is a chronic illness which generates uncertainty and other emotional problems among the relatives of persons who suffer alcoholism. Social support and spirituality are some coping mechanisms which could reduce uncertainty and favor the physical and psychological wellbeing. Objective: To determine the relationship and the effect of social support and spirituality on the uncertainty experienced by relatives of alcohol dependent persons. Methods: This is a descriptive and correlational study. The sample was constituted by 135 women members of Al-Anon. The Mishel Scale of Perception of Uncertainty among Parents and Family Members (PPUS-FM), the Sherbourne and Stewart Questionnaire, and the Reed Spiritual Perspective Scale were all used. Results: Significant negative correlation coefficients between uncertainty and social support (r s= -.356, p .05). and spirituality (r s= -.216, p .05). were identified. Using a univariate general linear regression model, it was determined that only social supports reduced uncertainty (β= -.280, t= -3.62, p= .001) with 11.5% of variance explained; while spirituality did not produce any effect (β = -.041, t= .218, p >.05). Conclusions: Social support is identified as a coping mechanism which can be used by nursing staff to develop interventions aimed at reducing uncertainty among relatives of alcohol dependent persons.

Resumo Introdução: A dependência do álcool, considerada como uma doença crónica, é um gatilho de incerteza para o familiar da pessoa com dependência, o qual gera transtornos emocionais negativos. O suporte social e a espiritualidade são mecanismos de enfrentamento que poderiam diminuir a incerteza e favorecer o bem-estar tanto físico, quanto psicológico. Objetivos: Determinar a relação e o efeito do suporte social e a espiritualidade sobre a incerteza do familiar da pessoa dependente de álcool. Métodos: Estudo descritivo e correlacional, amostra de 135 mulheres pertencentes aos grupos Al-Anon, utilizaram-se a Escala de Percepção de Incerteza em Pais e Membros da Família (PPUS-FM) de Mishel, o questionário MOS-SSS de Sherbourne e Stewart e a Escala de Perspectiva Espiritual elaborada por Reed. Resultados: Identificou-se um coeficiente de correlação negativo e significativo da incerteza com o apoio social (r s= -.356, p <.01) e a espiritualidade (r s= -.216, p <.05). Mediante um modelo de regressão linear geral univariado determinou-se que unicamente o apoio social influencia a diminuição da incerteza (β= -.280, t= -3.62, p= .001) com um coeficiente de determinação ou variância explicada do 11.5%, enquanto a espiritualidade não mostrou efeito (β= -.041, t= .218, p >.05) sobre a incerteza. Conclusões: O suporte social é identificado como um mecanismo de enfrentamento eficaz que permitirá ao pessoal de enfermagem desenvolver intervenções dirigidas a reduzir a incerteza em familiares de pessoas com algum tipo de dependência.

Enfermedad de Darier vesiculo ampollosa: descripción de un caso y revisión de la literatura / Vesiculobullous Darier’s disease: a case report and review of the literature

Describimos el caso de un varón de 57 años con enfermedad de Darier clásica diagnosticada a los 22 años que coincidente con una bronconeumonía muestra un brote de enfermedad de Darier vesículo-ampolloso. El brote remite con la curación del proceso infeccioso y retinoides sistémicos.Analizamos los posibles desencadenantes de la enfermedad de Darier vesículo-ampollosa en este caso, así como una revisión de todos los descritos hasta ahora en la bibliografía (AU)

A 57 years-old man with classical Darier’s disease diagnosed at 22 years is reported. The patient, coinciding with a bronchopneumonia, shows an outbreak of vesiculo-bullous Darier`s disease is reported. It disappears with the healing of the infection and systemic retinoids. We analyze the potential triggers of the vesiculo-bullous variant of Darier`s disease, as well as a review of the literature is performed (AU)

Olmsted syndrome: report of a new case.

We report the case of a 20-year-old man, who was born with an intense erythema of the genital area, unresponsive to any treatment employed. When he was 9 months old, he presented with well-defined hyperkeratotic erythematous plaques around the mouth, eyes, nose, and perianal area, with similar plaques on the lateral aspect of the neck and axillae. At the same time the erythema of the genital area became hyperkeratotic. When he was 2 years old, he presented with a disabling palmoplantar keratoderma, initially focal, and later diffuse, also unresponsive to local or systemic treatments employed. The lesions have varied during the course of the disease without ever clearing completely. The axillary and inguinal plaques have shown spontaneous resolution on occasion. Six skin biopsies have been performed with no conclusive histological diagnosis of any of the typical disorders of keratinization. All treatments, topical and systemic, including etretinate and acitretin, have failed to improve the condition. We believe that this patient has Olmsted syndrome, a rare form of palmoplantar keratoderma with periorificial keratotic plaques.

[A case of Sweet's syndrome associated with Crohn's disease]. / Un caso de síndrome de Sweet asociado a enfermedad de Crohn.

The Sweet syndrome or acute febrile neutrophilic dermatosis is a well characterized cutaneous disease from a clinical and histological point of view and is frequently associated with systemic diseases. Prognosis is favorable with good response to corticoid therapy. A well documented case of Sweet syndrome associated with an outbreak of Crohn's disease with peculiar good therapeutic response is reported.

[Kawasaki syndrome]. / Síndrome de Kawasaki.

Kawasaki syndrome is not usual in our country. We report this case to stress the clinical importance of this syndrome in which dermatological signs predominate.

[Eosinophilic fasciitis. Response to treatment with cimetidine]. / Fasceitis eosinofílica. Respuesta al tratamiento con cimetidina.

Eosinophilic fasciitis is a syndrome of imprecise classification which usually responds well to corticosteroids. We report a patient who did not respond to such treatment but he improved with cimetidine therapy. The pathogenesis of this syndrome and the possible action mechanism of cimetidine are discussed.

[Kaposi's sarcoma as the first manifestation of AIDS]. / Sarcoma de Kaposi como primera manifestación de un SIDA.

We report herein a case of Acquired Immunodeficiency Syndrome in a 38 years old man with Kaposi's sarcoma, which evolution was fulminant in some months. The clinical, pathological and pathogenic characteristics of Kaposi's sarcoma in this syndrome are discussed.

[Peripheral blood lymphocyte populations in 2 cases of Behçet syndrome]. / Estudio de las poblaciones linfocitarias en sangre periférica en dos casos de síndrome de Behçet.

The lymphocytes subsets in peripheral blood were studied in two patients with Behçet's syndrome. The finding about the decrease of T lymphocytes with the ratio elevated and specially the increase of B lymphocytes favors the hypothesis of predominance of the antibody formation over the cellular cytotoxicity.

[Pseudocysts of the auricle. Clinical and histological studies of 3 cases]. / Pseudo-kystes du pavillon auriculaire. Etude clinique et histologique de trois cas.

Three cases of pseudocyst of the auricle were studied. All three occurred in male, 38, 54, and 23 years old; all had a solitary nodule of the anthelix. Such pseudocyst have a characteristic localization and are not caused by trauma and have a serous, cystic content. The cystic formations develop from degeneration and liquefaction within the auricular cartilage. We believe that the name proposed by Engel "pseudocyst of the auricle" can be appropriated.