Cuidados de enfermagem para conforto de pessoas com dermatoses imunobolhosas: avaliação pela lógica fuzzy / Nursing care to comfort people with immunobullous dermatoses: evaluation by fuzzy logic / Cuidados de enfermería para la comodidad de personas con dermatosis inmunoampollares: evaluación por la lógica fuzzy

Objetivos: avaliar se as intervenções propostas na tecnologia de cuidados de enfermagem ao cliente com dermatoses imunobolhosas contribuem para reduzir o desconforto, reconhecer padrões de desconforto antes e após aplicação da tecnologia. Método: aplicação do protocolo de avaliação em 14 clientes hospitalizados em enfermarias de dermatologia do Rio de Janeiro e Mato Grosso do Sul, Brasil. Os cuidados foram realizados mediante diagnósticos identificados e recomendações da tecnologia. A subjetividade em reco¬nhecer padrões de conforto em clientes com doenças raras direcionou o uso da lógica fuzzy em função dos atributos dor, mobilidade, padrão de sono, exposição do corpo/lesões. Aprovado conforme CAAE: 0258.0.228.000-11. Resultados: dos 14 participantes, oito verbalizaram redução da dor após 24 horas. Após uma semana, três declararam maior redução, cinco manutenção e cinco aumento. Conclusão: a análise inferencial fuzzy propiciou avaliar padrões de desconforto, apontando para a veracidade da hipótese de que a tecnologia contribui para promover o conforto da clientela.

Objectives: to evaluate whether interventions proposed in nursing care technology for clients with immunobullous dermatoses contribute to reducing discomfort, and to recognize patterns of discomfort before and after application of the technology. Method: the evaluation protocol was applied to 14 patients hospitalized in dermatology wards in Rio de Janeiro and Mato Grosso do Sul, Brazil, from June 2012 to April 2013. Care was performed by way of identified diagnoses and recommendations in the technology. The role of subjectivity in rec¬ognizing comfort patterns in clients with rare diseases indicated the use of fuzzy logic with attributes of pain, mobility, sleep pattern, and body exposure/lesions. The study was approved under CAAE: 0258.0.228.000-11. Results: of the 14 patients, eight reported diminished pain after 24 hours. After one week, three reported larger reductions; five, no change; and five, increased pain. Conclusion: evaluation of patterns of discomfort by fuzzy inferential analysis supported the hypothesis that the technology contributes to promoting client comfort.

Objetivos: evaluar si las intervenciones propuestas en la tecnología de cuidados de enfermería al cliente con dermatosis inmunoampollares contribuyen a reducir el incómodo; reconocer patrones de incomodidad antes y después de la aplicación de la tecnología. Método: aplica¬ción del protocolo de evaluación en 14 pacientes hospitalizados en enfermerías de dermatología de Río de Janeiro y Mato Grosso do Sul, Brasil, de junio/2012 a abril/2013. Los cuidados se han realizado mediante diagnósticos identificados y recomendaciones de la tecnología. La subjetividad en reconocer patrones de comodidad en pacientes con enfermedades raras dirigió el uso de la lógica fuzzy en función de los atributos dolor, movilidad, patrón de sueño, exposición del cuerpo / lesiones. Aprobado conforme CAAE: 0258.0.228.000-11. Resultados: de los 14, ocho reportaron reducción del dolor después de 24 horas. Tras una semana, tres declararon una mayor reducción, cinco mantu¬vieron y cinco aumentaron. Conclusión: el análisis inferencial fuzzy propició evaluar patrones de incomodidad, señalando la veracidad de la hipótesis de que la tecnología contribuye a promover la comodidad de los pacientes.

Abordaje de lesiones por pénfigo ampolloso en prolapso genital / Addressing bullous pemphigoid wounds in genital prolapse

Las enfermedades bullosas o ampollares comprenden un grupo heterogéneo de cuadros cuya lesión elemental común es la ampolla. Los pénfigos y los penfigoides pertenecen al grupo de las enfermedades bullosas de origen autoinmunitario. El prolapso genital es el descenso o desplazamiento de los órganos pélvicos, a través de la vagina y en dirección a la vulva, que se produce como consecuencia del fallo de sus elementos de suspensión y sustentación así como la inervación y musculatura del sistema urinario e intestinal. En este caso presentamos nuestra experiencia en el manejo y tratamiento tópico de lesiones por pénfigo ampolloso en prolapso visceropélvico total que dificultaban la cirugía

Bullous and blistering diseases of the skin comprise a heterogeneous group of symptoms, which are essentially characterized by a common injury: blisters. Pemphigus and pemphigoid disorders are classified as blistering autoimmune diseases. The genital prolapse is the falling down or displacement of the pelvic organs through the vagina or towards the vulva, and which results from the loss of support structure and innervation and from a weak muscular tissue in both the urinary and intestinal system. What we are trying to show here is our experience and expertise in the care, management and topical treatment of bullous pemphigoid wounds in severe pelvic viscera prolapse, which used to make surgery difficult

[The role of nurses in dermatology]. / Le rôle des infirmières en dermatologie.

The range of care provided to patients by the dermatology nursing team is wide. Alleviation of pain and itching, improvement of skin integrity through hygiene care and local treatments, the cleaning of wounds and the changing of dressings, psychological treatment and therapeutic education are the main areas in which the nurse is involved.

When wounds do not heal: a case study.

The maintenance of skin integrity is a potentially challenging problem for critical care nurses. A multidisciplinary approach with creative thinking often is required. This article presents a case study illustrating the nursing interventions used in managing a patient's multisystem disorder that had been complicated by poor skin integrity. Nursing approaches to the psychosocial issues encountered by the patient, family, and health care professionals are also described.

Hospice health care: management of a case of bullous pemphigoid utilizing the hospice interdisciplinary team.

An association between bullous pemphigoid and internal malignant neoplasms has been reported by many authors, primarily in case report formats. Stone and Schroeter, however, compared cases of bullous pemphigoid with age and sex-matched control patients with contact dermatitis and psoriasis and found no evidence of an increased association between malignant neoplasms and bullous pemphigoid. A few cases of bullous pemphigoid occurring after radiation therapy for malignant neoplasms have been reported. A case of bullous pemphigoid which occurred after radiation therapy for squamous carcinoma of the cervix is presented. The interactive intervention of a hospice interdisciplinary team was crucial to the care and resolution of this patient's dermatological condition. Medical, psychological, and social aspects of the case are discussed.