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Transplant Proc ; 52(5): 1303-1307, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32466954


BACKGROUND AND AIMS: Assessment is considered a duty, as well as a part of the tasks of social workers; in addition, they have an ethical commitment to improve their working tools. This study aimed at validating the Adapted Social Assessment Instrument used in a transplant center in the state of São Paulo, Brazil, for liver transplantation candidates, requiring its improvement and strengthening. METHODS: The methodology was based on both Marxian dialectics and the method of content validation. The content validation analysis was performed by 5 social workers from 3 Brazilian transplant centers. They evaluated the 5 domains of the instrument: identification, socio-demographic profile, eligibility criteria, evaluation, and social interventions. Descriptive statistics of data were performed, and qualitative analysis was associated to the participant observation. RESULTS: The 5 professionals (100%) assigned the scores 3 and 4, which have demonstrated clarity, relevance, and feasibility, pointing out suggestions for improvement, some of which were considered. CONCLUSIONS: The instrument was evaluated with an approval percentage of above 80%; therefore, the instrument is a valid measure.

Hepatopatias/psicologia , Transplante de Fígado/psicologia , Seleção de Pacientes , Testes Psicológicos/normas , Adulto , Brasil , Feminino , Humanos , Hepatopatias/cirurgia , Masculino , Período Pré-Operatório , Reprodutibilidade dos Testes , Inquéritos e Questionários
Transplant Proc ; 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32439334


BACKGROUND: Caring for a patient with chronic liver disease involves exposure to factors that increase family caregivers' vulnerability to developing mental disorders. This study reassessed the scores of burden, stress, and depression in informal (family) caregivers of patients with liver disease after liver transplant. METHODS: In this observational and descriptive study, the caregivers were reassessed for the same outcomes 4 to 10 years following the initial assessment pre-transplant. The data were obtained from the identification card, the interview script, the Brazilian version of the Caregiver Burden Scale, the Lipp Inventory of Stress Symptoms for Adults, and the Beck Depression Inventory. Descriptive statistics of pre- and post-liver transplant phases were calculated, and the Wilcoxon signed rank test was used to compare the burden scores. RESULTS: The 5 caregivers were women, with a mean age of 51.6 (SD, 8.38) years. All of the caregivers' (100%) burden score increased, 2 caregivers needed to seek some form of help, and 3 caregivers showed an indication of burden risk. Regarding stress symptoms, 3 caregivers (60%) maintained a score indicating no stress, 2 caregivers (40%) presented increased scores, and the predominant symptoms changed from psychological to physical. Regarding depression, 3 caregivers (60%) maintained the minimum level of symptoms for depression, and 2 caregivers (40%) presented increased scores. CONCLUSION: After liver transplant, caregivers' burden scores increased, and levels of stress and depression increased for caregivers who already showed symptoms in the pre-transplant phase.

Transplant Proc ; 52(5): 1365-1369, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32199649


OBJECTIVE: This article analyzes the effectiveness of a super-accelerated immunization schedule against hepatitis B in patients who have received a liver transplantation. METHODS: This is a quantitative and retrospective study based on secondary data of medical records from 177 patients who have received a liver transplantation at the Hospital de Base in São José do Rio Preto, São Paulo State, Brazil, between 1998 and 2016. RESULTS: From the total number of participants, 72.89% were male, 39.55% had a cirrhosis diagnosis with associated causes, 23.16% had hepatocellular carcinoma, 53.11% were classified according to Child-Turcotte-Pugh C score, 58.76% had the hepatitis C virus, 97.18% had received an unconventional immunization schedule, and seroconversion was 36.63% among those with an unconventional schedule. The fact that the patient had the hepatitis C virus was statistically significant considering the lack of protection of the vaccine against the hepatitis B virus; their chances were 5 times higher of not seroconverting at the end of the immunization schedule. CONCLUSION: The need for high immediate protection in a short term may justify using unconventional immunization schedules in patients who make it to the transplantation waiting list without any previous immunization.

Vacinas contra Hepatite B/administração & dosagem , Esquemas de Imunização , Hospedeiro Imunocomprometido , Transplante de Fígado , Vacinação/métodos , Adolescente , Adulto , Idoso , Brasil , Criança , Feminino , Hepatite B/imunologia , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
Arch. Health Sci. (Online) ; 26(2):, abri-set.2019.
Artigo em Português | LILACS | ID: biblio-1045938


Introdução: O fator social interfere na realização de um transplante hepático, podendo contraindicá-lo momentaneamente. Para a análise e intervenção na realidade social do sujeito/paciente, o assistente social utiliza um instrumental que, devido ao seu valor, necessita de implementações, dado o movimento social. Objetivo: Adaptar o instrumental de avaliação social utilizado na Unidade de Transplante de Fígado. Método: Estudo quanti-qualitativo, pesquisa de campo com amostra intencional (assistentes sociais de Unidade de Transplante, com experiência no uso de instrumental de avaliação), análise de dados na perspectiva dialética e observação participante. Resultados: Todos os assistentes sociais utilizavam e três apontaram sugestões de melhorias, sendo os itens meios de comunicação e renda familiar os de maior destaque para alterações. As sugestões específicas para determinada unidade e as que alterariam o score do sistema de avaliação não foram implementadas. A partir da observação participante, outras alterações e informações foram incluídas para melhorar e ampliar o instrumental de acordo com a necessidade observada no cotidiano profissional. Conclusão: As alterações realizadas na adaptação favorecem a abordagem das variáveis sociais no momento da avaliação e contribui para o registro das intervenções sociais. Além disso, avança na visão totalitária do sujeito e da realidade social.

Introduction: The social factor interferes with the performance of a liver transplant and may contraindicate it momentarily. For the analysis and intervention in the social reality of the subject / patient, the social worker uses a tool that, due to its importance, needs implementations, due to the social movement. Objective: To adapt the social assessment tool used in the Liver Transplant Unit. Methods: Qualitative and quantitative approach study, field research with intentional sample (Transplant Unit social workers experienced in using assessment tools), data analysis was performed from a dialectical perspective and participant observation. Results: All social workers used it, and three pointed to suggestions for improvement, with media and household income being the most prominent items for change. Specific suggestions for a particular unit and those that would change the rating system score were not implemented. From participant observation, other changes and information were included to improve and expand the tool according to the need observed in the professional routine. Conclusion: Changes in adaptation favor the approach of social variables at the time of assessment and contribute to the registration of social interventions. Moreover, it advances in the totalitarian view of the subject and social reality.

Humanos , Masculino , Feminino , Estudos de Avaliação como Assunto , Condições Sociais , Transplante de Fígado , Condicionamento Operante , Determinação de Necessidades de Cuidados de Saúde , Adaptação , Assistentes Sociais
Radiol Case Rep ; 12(1): 196-199, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28228909


Immunoglobulin G4-related disease (IgG4RD) is an immune-mediated condition characterized by lymphoplasmacytic infiltrates and fibrosis of affected organs. IgG4RD may affect many different organs either individually or together in a multiorgan condition and, thus, incorporates a wide range of fibroinflammatory phenotypes with shared pathologic features. Although IgG4RD most commonly occurs in late adulthood, it may affect children and adolescents. Only one case of IgG4RD presenting as isolated submandibular gland involvement has been reported in the pediatric population. Radiographic features of IgG4RD are often nonspecific making diagnosis challenging, but it is important for radiologists to be familiar with this diseased as its inclusion the differential for diffuse salivary enlargement may be the first step in making an accurate diagnosis. Here, we report a case of a child presenting with bilateral submandibular gland swelling to increase awareness of this condition in the pediatric population. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Artigo em Inglês | MEDLINE | ID: mdl-18280949


OBJECTIVES: To evaluate the diagnostic value of intraoral palpation at the lateral pterygoid (LP) area as part of the physical examination to detect myofascial pain, according to modified research diagnostic criteria for temporomandibular disorders. STUDY DESIGN: Forty-four women composed the myofascial pain group, and 33 symptom-free age-matched were the control group. One examiner calibrated and blinded to group distribution performed 2 intraoral bilateral palpations of the lateral pterygoid. RESULTS: The LP area palpation showed sensitivity and specificity values of 79.55% and 77.27%, respectively, and positive and negative likelihood ratios of 3.50 and 0.26, respectively. CONCLUSIONS: Palpation at the LP area did not reach acceptable values of specificity, and care must be taken when judging positive response to this procedure.

Dor Facial/etiologia , Palpação , Músculos Pterigoides , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Medição da Dor , Sensibilidade e Especificidade , Síndrome da Disfunção da Articulação Temporomandibular/complicações