RESUMEN
La hemofilia adquirida A es una condición extremadamente rara que ocurre en una persona en un millón por año. Puede causar riesgo para la vida por causar episodios de sangrado durante la edad adulta, debido a la producción de auto-anticuerpos que inactivan el factor VIII. Su tratamiento suele incluir la inmunosupresión y la cirugía se debe evitar en lo posible. Presentamos dos casos que nos tocó tratar, y realizamos una recopilación somera de la bibliografia, a fin de enfatizar la necesidad de no realizar tratamiento quirúrgico en estos casos.
A hemofilia adquirida A é uma condição extremamente rara que pode ocorrer com a probabilidade de um caso em um milhão de pessoas por ano. Pode causar risco para a vida por causar episódios de sangramento durante a idade adulta, devido à produção de autoanticorpos que inativam o fator VIII. Seu tratamento geralmente inclui a imunosupressão, e a cirurgia deve, dentro do possível, ser evitada. Apresentamos dois casos por nós tratados, e realizamos um breve resumo da bibliografia, com a finalidade de enfatizar o propósito de não realizar tratamento cirúrgico nestes casos.
Acquired hemophilia A is an extremely rare disease with an incidence of 1 in 1,000,000 per year. It may be life threatening as it produces bleeding episodes in adult life, due to the production of antibodies which inactivate factor VIII. Treatment may include immunosuppression and surgery must be avoided as much as possible. We shall present two of our cases and then make a brief review of the literature, in order to underscore the need of not operating these cases.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Factor VIII/inmunología , Hemofilia A/diagnóstico , Hemofilia A/terapia , Factores de Riesgo , Trastornos HemorrágicosRESUMEN
This article described certain aspects of Haitian life, voodoo and its role in Haitian society, the quality and quantity of psychiatric and mental health care for Haitians in Haiti, and suggestions for providing appropriate mental health care to Haitian refugees in the United States. Conway and Buchanan (1985) described what has helped Haitian refugees adapt in the transition to life in the United States: the strengths from their cultural heritage, such as fortitude; perseverance in the most arduous circumstances; deep religious faith; high self-respect; reliance on the extended family; and the tradition of sharing. Building on these assets may assist Western mental health-care providers in offering culturally sensitive mental health care to Haitians.
Asunto(s)
Actitud Frente a la Salud , Características Culturales , Cultura , Trastornos Mentales/psicología , Haití/etnología , Humanos , Trastornos Mentales/etiología , Trastornos Mentales/enfermería , Servicios de Salud Mental/organización & administración , Servicios de Salud Mental/normas , Refugiados , Estados UnidosRESUMEN
PIP: A study of village women in Haiti which presents baseline data from their responses to stylized health education pictures is reported. The study questioned the concept that pictorial messages were accurately recognized and self-explanatory to nonliterate Haitian village women. The investigator, who used a descriptive survey, sought answers to a major and a related question: what do nonliterate Haitian village women recognize in selected health education pictures; and are their differences in picture recognition traceable to the complexity of the pictures. There were 110 women (25 from a mountain village, 25 from a plains village, 25 from a seacoast village, and 35 urban dwellers) who responded to 9 health education pictures. The women ranged in age from 18-80 years of age; 32 (29%) had gone to school for a range of an "unknown time" to 8 years. 47% of those who had gone to school indicated that they could read. The investigator rated the verbatim responses to the pictures for accuracy as: accurate, overinclusive, underinclusive, inaccurate, and do not know. The quantitative analysis of this data revealed that the accuracy levels decreased as the complexity level increased. This is best shown in the 129 (39%) accurate responses in the low level; 6 (1.8%) in the moderate level; and no accurate responses in the high complexity level. An unexpected finding was the highest number of inaccurate responses (n = 83, 25.1%) found in the low complexity level, while the moderate and high levels both showed 36 (10.8%). In addition to the differences in accuracy in picture recognition based on picture complexity, there were significant differences on the chi-square test which confirmed the assertion of the question that picture recognition is traceable to the complexity of the picture. These findings are consistent with the picture complexity studies of Holmes, Jelliffe, and Kwansa.^ieng