Palliative Sedation in Children and Adolescents: the Repercussion in the Family

Background: Estimative demonstrate about 6% of the 20 million people needing palliative care at the end of their life are less than 15 years old. Despite of that, researchers reported several areas of parent dissatisfaction with care including confusing, inadequate, or uncaring communications with clinicians regarding treatment or prognosis of the child’s end of life. Objective: Here we show that about 90% of the families that have a child or an adolescent passing through a situation that needs Palliative Sedation think that this process was necessary to relieve the suffering of the patient. Results: In several reports, parents of terminally ill children describe their perceptions of uncaring and insufficient communication from health care professionals and link that communication with their own lingering regrets and emotional distress. Conclusion: There is the necessity to better capacity the supportive and care team, in order to diminish guilty and grieve feelings, and to provide courses to the care team that can develop the communication process among them and the family

TERAPIA FOTODINÂMICA PARA O TRATAMENTO DA PERIIMPLANTITE

Peri-implantitis has been described as a pathological change in the tissue surrounding the dental implants, being the microbiota one of the main etiological condition and it’s the most focused in this review. One alternative therapy to the conventional treatment of peri-implantitis is the antimicrobial photodynamic therapy (aPDT), that has features as bioestimulation, inflammation modulation, analgesia and bactericidal. This literature review’s objectives are to analyze and compare the treatments that embraces aPDT This review includes treatments studies with and without surgical debridement and associated with medicines. This reviews goal is to point out, through scientifical findings, the treatment that have provided most scientifical evidences of effectiveness in the treatment of peri-implantitis. It was included articles found through bank data from Medline, Lilacs, Scielo and Google Scholar that included the following keywords: Peri-implantitis, Photodynamic Therapy, Laser Therapy. All articles analysed during this review are clinical studies to compare the results. Although the treatment’s parameters of peri-implantitis aren’t completely defined, studies suggests that the treatment that provided better results in this situation was the aPDT with surgical debridementA peri-implantite vem sendo descrita como uma alteração patológica nos tecidos ao redor dos implantes dentários, sendo a microbiota um dos principais fatores etiológicos, e é o mais focado no caso dessa revisão. Uma terapia alternativa ao tratamento convencional da peri-implantite é a Terapia Fotodinâmica Antimicrobiana (TFA), que possui características específicas. Os lasers de baixa potência utilizados na TFA possuem propriedades como bioestimulação, modulação da inflamação, analgesia e bactericida. Essa revisão de literatura teve como objetivo analisar e comparar os tratamentos para a peri-implantite que envolvem a TFA. Inclui-se nessa revisão de literatura estudos que compararam a TFA com e sem debridamento cirúrgico e uso de medicamentos associados, apontando por meio de achados científicos, o método que mais se apresentou eficaz no tratamento da peri-implantite. Foram utilizados artigos encontrados através dos bancos de dados Medline, Lilacs, Scielo e Google Acadêmico, por meio dos termos Peri-Implantite; Terapia Fotodinâmica e Terapia a Laser. Todos os artigos analisados durante a revisão são de estudos clínicos para a comparação dos resultados. Embora os parâmetros para o tratamento da peri-implantite não estejam completamente definidos, os estudos analisados sugerem que o tratamento que apresentou melhores resultados nesse quesito, foi o de TFA com debridamento cirúrgico, no entanto, sem melhoras significativas em relação ao tratamento convencional

Ebola: an international public health emergency

The outbreak of Ebola in West Africa could become one of the worst infectious-disease-driven humanitarian crises of recent times. With more than 3000 deaths since the first case was confirmed in March 2014, the international community has recognized Ebola as a public health emergency of international concern and a clear threat to global health security. The complexity of dealing with this Ebola outbreak has highlighted the need for traditional actors, such as WHO and the CDC, to embrace the wider health and humanitarian community. The epidemic reinforces the need for nations to investment in health infrastructure and disease surveillance to keep pace with other developments in Africa. If Ebola arrives in high-income and middleincome nations, it should be contained quickly. The crisis shows the importance of sufficient levels of multilateral funding for WHO. The world needs a strong WHO, with the financing and political influence to fulfil its historic mission

Bioethics Inserted in Oncologic Palliative Care: a Systematic Review

Introduction: Bioethics emerges in oncologic palliative care from the reflctions of that care at the end of life for cancer patients are usually inadequate because the individuals has little relief of symptoms, adverse reactions to treatment, threats of physical, social and psychological destruction and loss of functions.Material and Findings: Systematic review in MEDLINE, IBECS, LILACS and SciELO from 1 st January, 2006 to 10th January. The searchvwas conducted with the descriptors "CuidadosPaliativos" (DeCS);"Oncologia" (DeCS); "Morte e Morrer" (Keyword); and "Bioética" (DeCS) during the month of December 2013. The literature points out that physicians should not accept something as absolute truth; and to help them in their choices at the moment comes to bioethics, which does not provide ready answers, but, with its pluralistic view, makes us exercise the capacity for reflction in choosing the best conduits for the patient. It is necessary to rescue more widely the value of the care that was in the background before the search for the cure of diseases, which in a broader sense, encompasses human, spiritual and social aspects. In Brazil, the practice of euthanasia or assisted suicide are illegal conduct that typify the crime of murder, however, the suspension of therapeutic effort is not prohibited (SET), extensively comment, orthothanasia.Conclusion: Despite the possible philosophical and ideological differences, it is necessary that health professionals to really take care of severe patients, prove conscious and attentive to the rights of the individual, the real meaning of the concepts of health and disease, issues the lack of therapeutic possibilities, extreme old age and death