Psychoanalytic Psychotherapy with Deaf Patients: A Qualitative Study of Characteristics and Technical Adaptations in Clinical Practice

How do deaf patients treat their psychological conflicts? Is psychoanalytic psychotherapy possible for this population? Should adaptations be made in the psychotherapeutic setting? Many deaf people have come to psychotherapists’ offices in search of care for their emotional suffering only to encounter professionals who are unprepared, at least technically, to work with these patients and their differences. Due to the scarcity of publications or because very few professionals work with this population, many psychoanalysts are obliged to develop treatment in a basically intuitive way. The main objective of this study is to describe characteristics and technical adaptations carried out when treating this group through psychoanalytic psychotherapy as exercised by professionals who are familiar with the area. This article is the result of qualitative research backed up by very diverse reading. Content analysis was carried out according to Bardin's widely accepted method, and resulted in three final categories that are discussed. The categories are: (1) professional experience in the field of deafness: preparation and initial difficulties; (2) contextualization and subjectivity of deaf patients; (3) a psychoanalytic approach with deaf patients: characteristics and technical adaptations of clinical practice.     

Clinical manifestations in term newborn infants with different degrees of acidemia in umbilical cord blood

OBJECTIVE: To verify if Apgar score plus umbilical cord pH are adequate to predict which newborn infant will develop multiorgan system disfunction. METHODS: A study including all term newborn infants with Apgar scores in the first and fifth minutes of life < 7 and umbilical cord blood pH < 7.20 born in Hospital de Clínicas de Porto Alegre from March 1995 through March 1998 was performed. Venous umbilical cord blood was collected for blood gas analysis. Newborn infants were divided in two groups: Group A with pH < 7.0, and Group B with pH >/= 7.0 and < 7.20. Patients were evaluated for the presence of pulmonary hypertension, renal failure, inappropriate secretion of antidiuretic hormone, ischemic cardiopathy, early seizures, neurologic injury at hospital discharge and death. RESULTS: Twenty five newborn infants were included in the study.Twelve formed Group A, and 13, Group B. There were no differences between both groups in respect to mode of delivery, gender, color and birth weight. Group B had a lower gestational age than Group A. There were significant differences between both groups in mean cord blood pH, pCO(2) and BE (p<0.05). There was a positive association between umbilical cord blood pH and Apgar score. Higher occurrence of neurologic injury at hospital discharge in Group A was the only statistically significant clinical manifestation (p<0.05). CONCLUSION: Apgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.     

Use of highly sensitive mitochondrial probes to detect microchimerism in xenotransplantation models

Chimerism, defined as the co-existence of cells of different origin within the same organism, has received much attention in hematopoietic cell and organ transplantation because of the strict relationship between its establishment and the induction of specific tolerance. Traditional methods applied for chimerism detection, such as immunohistochemistry, cytogenetics, fluorescent-activated cell sorter analysis, and serological and biochemical testing, are limited by their sensitivity. We have established a highly sensitive molecular approach based on the amplification of the mitochondrial cytochrome B gene and tested its specificity and sensitivity level in six different mammalian species, including human, pig, mouse, rat, sheep and rabbit. Increased sensitivity of detection of specific amplification products was obtained by the non-radioactive Southern blot technique. This novel approach allows the detection of one cell against the background of 1 to 4 x 10(6) xenogenec cells and will be helpful for high-sensitivity analysis of donor cell engraftment after xenotransplantation procedures in these animal models.     

Congenital corneal anesthesia related to trigeminal anesthesia: case report

Corneal anesthesia is a rare condition, therefore its diagnosis is frequently impaired or it is not noticed during the anterior segment examination. Case report of a 18-year-old patient referred to our Corneal and External Disease Department who complained of dry eye symptoms and with a suspicion of Sj?gren's syndrome. She had amblyopia of the right eye, consequence of corneal leucoma over the visual axis secondary to a fingernail traumatism inflicted by herself in childhood. On the ophthalmologic examination corneal sensitivity was absent in both eyes. Severe dry eye and breakup time less than four seconds. Diagnosis of congenital corneal anesthesia was established, secondary to trigeminal anesthesia found on neurological evaluation of facial sensitivity. She also showed sudden movements of the chin which evidenced sensorial pathology of the trigeminal nerve. The general ophthalmologist and specially anterior segment specialists must perform tests for corneal sensitivity during the routine eye examination.     

Placental transfer of naturally acquired,maternal cytomegalovirus antibodies in term and preterm neonates

Maternal antibodies may protect the fetus and neonate against severe forms of CMV-caused disease, therefore this study investigated the efficiency of the placental transfer of naturally acquired, maternal total anti-cytomegalovirus (CMV) IgG and neutralizing antibodies at different gestational ages. The study was conducted on 182 healthy CMV-seropositive Brazilian mothers and their 196 infants who were not infected congenitally with CMV, as determined by CMV detection in urine. The study groups were composed of 44 infants aged 28-30 weeks; 51 infants aged 31-33 weeks; 62 infants aged 34-36 weeks, and 39 infants of gestational age > or = 37 weeks. Quantitative detection of total CMV IgG was carried out using EIA and virus neutralizing titers were determined by a microneutralization assay in sera from mothers and infants. CMV IgG levels and neutralizing titers of the infants correlated with maternal levels (r=0.873 and r=0.841, respectively). The efficiency of placental transfer of these antibodies was enhanced significantly as gestation progressed until 34-36 weeks, when values similar to those of full-term infants (90-100%) were found. Transfer ratios were significantly higher for neutralizing compared to total CMV IgG antibodies at gestational age 31-33 weeks (100% vs. 84%, respectively) and at gestational age 28-30 weeks (75% vs. 60%, respectively). We conclude that placental transfer of naturally acquired maternal CMV neutralizing and total CMV IgG antibodies are similarly efficient above 34 weeks of gestational age. At less than 34 weeks of gestational age, transfer of neutralizing antibodies may be favored and these antibodies reach the neonatal serum of 99% of these premature infants.     

Study of the osteoconductive properties of bioactive glass fibers

Bioactive glass fibers have been prepared and implanted in cortical defect and in muscle. The fibers can act as a substrate for bone apposition, when implanted in a cortical defect, and become incorporated in the new bone matrix. The same results were obtained when fibers were implanted in a muscle pouch together with bone marrow cells. An intense inflammatory reaction was observed when bioactive glass fibers were implanted in muscle; the reaction was milder when fibers were implanted in bone or in muscle together with bone marrow cells. This fact supports the hypothesis that osteogenic cells adhere in an early phase to the substrate and prevent recognition of the foreign material by inflammatory cells. This appears to be a fundamental condition for direct bone matrix apposition on the surface of fibers.     

Studies on the extraction and purification of phytic acid from rice bran

The objective of this work was to develop rice bran IRGA 417 phytic acid (PA) extraction and purification techniques. For the extraction of PA, a complete 2⁴ factorial design with triplicates at the central point was used, and the effects of concentration of rice bran and HCl, time and temperature were investigated. During purification, different pH values were tested with addition of 1.5 M Na₂CO₃ or 4.0 M NaOH. The results obtained by the statistical analysis of the factorial design showed that temperature, time and HCl concentration influenced the PA extraction technique significantly (p ≤ 0.05), whereas the concentration of rice bran had no influence. The content of PA was evaluated in all the stages of purification and it was possible to establish an improved methodology of extraction and purification with high purity and yields.