Tissue banking (or biobanking), thought by many to be an essential form of medical research, has raised a number of ethical issues that highlight a need to understand the beliefs and values of tissue donors, including the motivations underlying consent or refusal to donate. Data from our qualitative study of the legal, social and ethical issues surrounding tumor banking in New South Wales, Australia, shows that participants’ attitudes to donation of tumor tissue for research are partially captured by theories of weak altruism and social exchange. However, we argue that the psychological rewards of value transformation described by Thompson’s rubbish theory provide additional insights into participants’ attitudes to tumor donation. We believe our data provides sufficient justification for an approach to regulation of tumor banking that is aimed at fostering a relationship based on the notions of virtuous reassignment and social exchange.  Keywords Ethics; genetics; research participation; risk perceptionsUniversity of Sydney Cancer Research Fun

Morrell, B

Lipworth, W

Axler, R

Kerridge, I

Little, M

English

Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.A gastrosquise é um defeito congénito da parede abdominal anterior, em geral situado à direita da inserção normal do cordão umbilical e através do qual ocorre a herniação de órgãos abdominais, mais frequentemente as ansas intestinais. Como resultado, há uma exposição direta destes órgãos ao líquido amniótico, que constituí um potencial agente irritativo e prejudicial. Em termos epidemiológicos, verifica-se atualmente um menor número de casos/ano em virtude das melhorias no diagnóstico pré-natal, variando a sua incidência entre 0,5 – 4,5 casos por 10 000 nados vivos. Coloca-se a hipótese de haver associação com alguns fatores de risco como a idade materna jovem, baixo estrato socioeconómico, bem como a ingestão de alguns fármacos, álcool e tabaco. As cromossomopatias ou malformações associadas são raras, sendo que, a existirem, geralmente afetam apenas o trato gastrointestinal (atresia ou estenose intestinal). O diagnóstico pré-natal permite a preparação do parto num centro especializado e subsequente intervenção cirúrgica precoce, minimizando, desta forma, o risco de sequelas.
Atualmente, a melhoria dos cuidados neonatais e o aparecimento de novas estratégias no tratamento cirúrgico desta patologia, permitiram um aumento da sobrevida e uma melhoria no prognóstico, sendo a atual taxa de sobrevivência superior a 90% nos países desenvolvidos.
O principal objetivo deste artigo de revisão consiste em descrever as principais opções terapêuticas cirúrgicas atualmente aceites para a gastrosquise, que incluem o encerramento primário ou estadiado, e abordar novas técnicas como o encerramento plástico ou por pressão negativa (sistema de vácuo). Concomitantemente, procedeu-se a uma análise crítica de alguns casos clínicos obtidos a partir da base dados do Hospital Pediátrico - Centro Hospitalar da Universidade de Coimbra (CHUC).Gastroschisis is a congenital anterior abdominal wall defect, generally located to the right with the umbilical cord normally inserted and through which the herniation of abdominal organs occurs, most commonly the intestinal loops. As a result, there is a direct exposure of
6
these organs to the amniotic fluid, which constitutes a potential irritant and harmful agent. Epidemiological data sugests that there is actually a smaller number of cases / year due to improvements in prenatal diagnosis, and its incidence varies from 0.5 to 4.5 cases per 10 000 live births. It has been hypothesized the association with certain risk factors, such as young maternal age, low socioeconomic strata and the intake of certain drugs, alcohol and tobacco. The chromosomal or associated malformations are rare, and, if there is any, usually it only affects the gastrointestinal tract (intestinal atresia or stenosis). Prenatal diagnosis allows for the preparation of the delivery in a tertiary center and subsequent early surgical intervention, thereby minimizing the risk of sequelae.
Currently, improved neonatal care and the emergence of new strategies in the surgical treatment of this disease, resulted in increased survival and improved prognosis, with the current rate of survival greater than 90% in developed countries.
The aim of this review article is to describe the main surgical treatment options currently accepted for gastroschisis, including primary or staged closure and address new techniques, like plastic closure or negative pressure (vacuum system). Concomitantly, it is presented a critical analysis of some clinical cases obtained from the database of the Paediatric Hospital - Hospital of the University of Coimbra (CHUC)

Dias, André Ferreira

Estudo Geral

Tratamento cirúrgico da gastrosquise: o estado da arte

Sydney eScholarship