Maria Teresa Aquino de Campos Velho

A perda do filho: luto e doação de órgãos

This article consists on a theoretical reflection which aims to understand the issues involved in the process of parental grief for the loss of their child. Through understanding the suffering caused by this experience we try to think about its implication regarding the organ donation procedure and the attitude that health professionals may assume to relieve parents suffering concerning the possibility of having their child as a potential donor. It also aims to cover ethical principles regarding the donation consenting process as well as to reflect about training the health care team to assist the family throughout grief and the organ donation process.

A voz do paciente: por que ele se sente coagido?

The process of informed consent is essential to guarantee patients the right to opine and decide on their medical treatment. However, the expression of coercion may be associated with this practice by restricting the autonomy and willingness of the subject. Accordingly, we sought to understand what factors had influenced the perception of coercion manifested by the research subjects. This is a qualitative study, with the completion of semi-structured interviews with six subjects who had some degree of perceived coercion. The interviews were analyzed using content analysis. It is observed that this identification by the patient, who had no voice in the treatment appears linked to the provision of information, the experiences with the hospital, and the elements as time linking to the institution, to gratitude and how the experiences were integrated psychically.

Adolescência, autonomia e pesquisa em seres humanos

This article makes considerations on the theme of adolescence as a single stage in peoples lives, the phase in which the autonomy gains increasing strength. Although the goal of the study is to discuss issues of epidemiological, clinical or pharmacological research with teenagers, we discuss aspects related to psychological, social and moral development of human beings. At the end, some concepts and guidelines applicable to those different types of researches involving human subjects are reviwed.Este texto hace algunas consideraciones sobre el tema de la adolescencia como una etapa unica en la vida de las personas, la fase en la que la autonomia adquiere mas fuerza. Aunque el objetivo del estudio es examinar las cuestiones de la investigacion epidemiologica, clinica o farmacologica con adolescentes, discutiremos aspectos relacionados con el desarrollo psicologico, social y moral de los seres humanos. Al final, vamos a revisar algunos conceptos y directrices que se aplican en estas investigaciones.

Aspiração manual intrauterina no tratamento do abortamento incompleto até 12 semanas gestacionais: uma alternativa à curetagem uterina

PURPOSE To analyze the effectiveness and occurrence of complications, in addition to hospitalization time and blood losses. METHODS Thirty patients were assigned alternatively and consecutively to one of two groups (15 to the Curettage Group and 15 to the Manual Vacuum Aspiration Group). The following variables were analyzed: effectiveness of the method, occurrence of complications, time before the procedure, time of execution of the procedure, time after the procedure, and total time of hospital permanence, in addition to hematocrit and hemoglobin, which were measured before and after the procedure. Patients were evaluated clinically 10 to 14 days after the procedure. Parametric and nonparametric tests were used for statistical analysis, with the level of significance set at p>0.05. RESULTS Both methods were efficient and no complications were recorded. Blood losses were similar in the two groups, but the hospitalization time was significantly shorter for the Manual Vacuum Aspiration Group (p=0.03). CONCLUSION Manual vacuum aspiration is as efficient and safe as uterine curettage, with the advantage of requiring shorter hospitalization, which increases the resolution of the method, improving the quality of care for these patients.

Determinação Ultra-sonográfica do Índice do Líquido Amniótico em Grávidas Normais, da 12ª à 42ª Semana de Gravidez

Objetivo: determinar o indice do liquido amniotico (ILA) por ultra-sonografia em gestacoes normais e construir uma curva de normalidade para o ILA da 12a a 42a semana de gravidez. Metodos: foram realizadas 471 medidas do ILA, em 256 gestantes sem intercorrencias clinicas maternas ou fetais. Em gestacoes acima de 20 semanas calculava-se a soma dos maiores diâmetros verticais dos bolsoes de liquido amniotico (LA) em quatro quadrantes nos quais era dividido o utero. Naquelas gestacoes com 20 semanas ou menos o utero era dividido em duas metades. A soma era calculada por meio das medidas obtidas dos maiores diâmetros verticais medidos nessas duas metades. O resultado da soma foi expresso em centimetros. Resultados: o ILA foi medido (471 medidas) e os resultados foram estratificados e agrupados por intervalos gestacionais (2 em 2 semanas), a excecao da 12a que foi analisada isoladamente. De uma media de 4,7 cm (limites 3,8-5,9 para o 5o e o 95o percentil) na 12a semana gestacional, o ILA cresceu progressivamente ate a media maxima de 14,7 cm na 32a semana (limites: 7,0-24,9 cm). Apresentou valores estaveis, em plato, da 21a ate a 40a semana, inclusive. Apos, os valores do ILA diminuiram acentuadamente. O ponto de corte do ILA foi verificado na 21a semana de gestacao. O incremento percentual do ILA verificado na 32a semana foi de 197,7% em relacao a 12a semana e no final da gestacao foi de 2,9% em relacao a semana tomada como referencia. Conclusao: o ILA apresentou variacoes no decorrer da gestacao. Cresceu progressivamente ate a 21a semana, apresentando, apos, valores em plato ate a 40a semana. Depois dessa semana, o ILA diminuiu acentuadamente. O pico maximo do ILA ocorreu na 32a semana. Ao se estabelecer uma curva de normalidade para o ILA, em nosso meio, facilita-se a deteccao de alteracoes e, com isso, um melhor acompanhamento e conducao da gravidez.

Adolescencia, autonomía e investigación en seres humanos

This article makes considerations on the theme of adolescence as a single stage in peoples lives, the phase in which the autonomy gains increasing strength. Although the goal of the study is to discuss issues of epidemiological, clinical or pharmacological research with teenagers, we discuss aspects related to psychological, social and moral development of human beings. At the end, some concepts and guidelines applicable to those different types of researches involving human subjects are reviwed.Este texto hace algunas consideraciones sobre el tema de la adolescencia como una etapa unica en la vida de las personas, la fase en la que la autonomia adquiere mas fuerza. Aunque el objetivo del estudio es examinar las cuestiones de la investigacion epidemiologica, clinica o farmacologica con adolescentes, discutiremos aspectos relacionados con el desarrollo psicologico, social y moral de los seres humanos. Al final, vamos a revisar algunos conceptos y directrices que se aplican en estas investigaciones.

Adolescence, autonomy and human research

This article makes considerations on the theme of adolescence as a single stage in peoples lives, the phase in which the autonomy gains increasing strength. Although the goal of the study is to discuss issues of epidemiological, clinical or pharmacological research with teenagers, we discuss aspects related to psychological, social and moral development of human beings. At the end, some concepts and guidelines applicable to those different types of researches involving human subjects are reviwed.Este texto hace algunas consideraciones sobre el tema de la adolescencia como una etapa unica en la vida de las personas, la fase en la que la autonomia adquiere mas fuerza. Aunque el objetivo del estudio es examinar las cuestiones de la investigacion epidemiologica, clinica o farmacologica con adolescentes, discutiremos aspectos relacionados con el desarrollo psicologico, social y moral de los seres humanos. Al final, vamos a revisar algunos conceptos y directrices que se aplican en estas investigaciones.

The patient's voice: why he feels coerced?

The process of informed consent is essential to guarantee patients the right to opine and decide on their medical treatment. However, the expression of coercion may be associated with this practice by restricting the autonomy and willingness of the subject. Accordingly, we sought to understand what factors had influenced the perception of coercion manifested by the research subjects. This is a qualitative study, with the completion of semi-structured interviews with six subjects who had some degree of perceived coercion. The interviews were analyzed using content analysis. It is observed that this identification by the patient, who had no voice in the treatment appears linked to the provision of information, the experiences with the hospital, and the elements as time linking to the institution, to gratitude and how the experiences were integrated psychically.

La voz del paciente: ¿por que se siente coercionado?

The process of informed consent is essential to guarantee patients the right to opine and decide on their medical treatment. However, the expression of coercion may be associated with this practice by restricting the autonomy and willingness of the subject. Accordingly, we sought to understand what factors had influenced the perception of coercion manifested by the research subjects. This is a qualitative study, with the completion of semi-structured interviews with six subjects who had some degree of perceived coercion. The interviews were analyzed using content analysis. It is observed that this identification by the patient, who had no voice in the treatment appears linked to the provision of information, the experiences with the hospital, and the elements as time linking to the institution, to gratitude and how the experiences were integrated psychically.