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Georgiana Russu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

ASPECTE PSIHOLOGICE SI ETICE LEGATE DE PREZENTA MEMBRILOR FAMILIEI IN TIMPUL RESUSCITARII CARDIACE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ASPECTE PSIHOLOGICE SI ETICE LEGATE DE PREZENTA MEMBRILOR FAMILIEI IN TIMPUL RESUSCITARII CARDIACE LA COPIL

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REZUMAT

Prezenţa membrilor familiei pe parcursul investigaţiilor medicale a determinat dezbateri intense. Aceste dispute au avut în centrul lor atât aspectele etice, psihologice, cât şi politice. Autorii abordează teoretic aspecte legate de prezenţa familiei pe parcursul intervenţiilor medicale în cazul copiilor cu probleme cardiace, în special al manevrelor de resuscitare. În acest domeniu s-au acumulat argumente şi contra-argumente generate de politicile de sănătate din diverse ţări, nivelul de colaborare al familiei, pregătirea specială a medicilor şi a întregii echipe implicată în resuscitare, includerea participării familiei în protocoalele de lucru şi crearea condiţiilor pentru desfăşurarea resuscitării în această modalitate.

Cuvinte cheie: copil, deficienţe cardiace, malformaţii, resuscitare, familie, distres psihologic, terapie

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PSYCHOLOGICAL AND ETHICAL ASPECTS OF THE PRESENCE OF FAMILY MEMBERS DURING CARDIAC RESUSCITATION IN CHILDREN

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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PSYCHOLOGICAL AND ETHICAL ASPECTS OF THE PRESENCE OF FAMILY MEMBERS DURING CARDIAC RESUSCITATION IN CHILDREN

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ABSTRACT

The presence of family members during medical investigations has given rise to intense debates. These disputes had at their center ethical, psychological and political issues. The authors approach, from a theoretical perspective, aspects related to the presence of family during medical interventions in children with cardiac problems, especially during cardiac resuscitation procedures. This field has accumulated the pros and cons
generated by health policies in various countries, the level of collaboration of the family, the special training of doctors and of the whole cardiac resuscitation team, the participation of the family in work protocols and the creation of conditions for conducting cardiac resuscitation in this manner.

Keywords: child, cardiac deficiencies, malformations, cardiac resuscitation, family, psychological distress, therapy

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PERTURBAREA AUZULUI – COMPONENTA A SINDROMULUI ALCOOL FETAL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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PERTURBAREA AUZULUI – COMPONENTA A SINDROMULUI ALCOOL FETAL

, and

REZUMAT

Sindromul alcool fetal (SAF) (1-2/1.000 nou-născuţi viabili), consecinţă a ingestiei precoce de alcool în timpul gravidităţii, asociază: deficienţa persistentă a creşterii taliei, greutăţii şi circumferinţei craniene, anomalii faciale caracteristice, malformaţii cardiace (predomină defectele septale), anomalii minore ale articulaţiilor şi extremităţilor, deficienţe ale dezvoltării şi funcţiei sistemului nervos central. Complexitatea, gravitatea şi frecvenţa modificărilor este variabilă în funcţie de consumul de alcool asociat sau nu altor riscuri: status socioeconomic scăzut, perturbări psihologice, fumat, droguri. Afectarea auzului sub efectul alcoolului, neinclusă clasic în sindromul alcool fetal precum şi infecţiile cronice ale urechii se asociază cu grade variabile de severitate. Examinările de specialitate aplicate sistematic la copiii cu SAF mai mult sau mai puţin sever au dus la conturarea a patru tipuri principale de perturbări ale auzului: întârzierea dezvoltării funcţiei auditive asociată cu perturbări ale vorbirii, pierderea neuro-senzorială a auzului (afectarea urechii medii şi a căilor auditive), pierderi intermitente ale funcţiei de conducere a vibraţiilor sunetului, pierderea auzului prin leziuni centrale. Identificarea precoce a anomaliilor de auz, de origine conductivă sau neuro-senzorială, contribuie la ameliorarea prognosticului prin intervenţii recuperatorii precoce.

Cuvinte cheie: alcool, sarcină, hipoacuzie.

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HEARING DISORDERS – PART OF FETAL ALCOHOL SYNDROME

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HEARING DISORDERS – PART OF FETAL ALCOHOL SYNDROME

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ABSTRACT

Fetal alcohol syndrome (FAS) (1-2/1000 newborns), resulting from maternal consumption of alcohol early in the pregnancy, consists in: persistent growth failure, low weight, microcephaly, characteristic facial features, congenital heart diseases (especially septal defects), minor anomalies of joints and limbs, disorders of central nervous system development and function. The complexity, severity and frequency of the anomalies depends on the amount of the ingested alcohol associated or not with other risk factors: low socio-economic level, psychologic disturbances, smoking, drugs. Hearing disorders determined by maternal alcohol consumption, although not classically included in the FAS, and also chronic ear infections, are associated in variable severity degrees. Audiologic procedures performed in FAS children revealed four main hearing disorders: delayed development of auditory function associated with language disorders, sensorineural hearing loss (disorders of middle ear and conductive system), intermittent loss of sound vibrations conduction, hearing loss by central auditory nervous system deficits. Early detection of hearing anomalies alleviates the prognosis by early interventions.

Keywords: alcohol, pregnancy, hearing loss.

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DILEME ETICE IN SARCINA CU MALFORMATII FETALE

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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DILEME ETICE IN SARCINA CU MALFORMATII FETALE

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REZUMAT

Malformaţiile congenitale de cord, cu o incidenţă de 6-8/1.000 de nou-născuţi, reprezintă aproximativ 30% dintre cazurile de mortalitate infantilă determinate de anomalii congenitale. Dintre acestea, o mare parte necesită intervenţie chirurgicală corectoare imediat în perioada neonatală. Malformaţiile rinichilor şi tractului urinar au o incidenţă de aproximativ 1%. Dezvoltarea tehnicilor de ecografie fetală a permis diagnosticarea prenatală a multor malformaţii, unele cu risc vital. Astfel, apar probleme deosebite de etică privind întreruperea sarcinii sau îndrumarea gravidei către un centru unde nou-născutul va putea fi operat în primele ore de viaţă.

Cuvinte cheie: decizii etice, nou-născut, malformaţii congenitale de cord, malformaţii renale, ecografie fetală

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ETHICAL DILEMMA IN THE PREGNANCY WITH FETAL MALFORMATIONS

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ETHICAL DILEMMA IN THE PREGNANCY WITH FETAL MALFORMATIONS

and

ABSTRACT

Congenital heart malformations, with an incidence of 6-8/1,000 births, represent about 30% of cases of infant mortality due to congenital abnormalities. Of these, most require immediate corrective surgery in the neonatal period. Kidney and urinary tract malformations have an incidence of approximately 1%. The development of ultrasound techniques allowed for prenatal diagnosis of many fetal malformations, some of them lifethreatening. Thus, important ethical problems occur, concerning abortion or guidance of the pregnant woman to a center where the newborn will be operated in the first hours of life.

Keywords: ethical decisions, newborn, congenital heart defects, kidney malformations, fetal ultrasound

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Transient hypertrophic cardiomyopathy in newborn

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Transient hypertrophic cardiomyopathy in newborn

ABSTRACT

Myocardial contraction and relaxation is continuously changing during fetal life and during transition from newborn to adult stage. The newborn heart is structurally and functionally immature facing to various aggressive factors it has to respond, and it is the target of perinatal stress. Many changes are attributed to perinatal ischemia (heart failure, mitral and tricuspid regurgitation, ischemic ECG changes), but also to the endogen hyperinsulinism induced to the fetus by the diabetic mother. Echocardiography is the main noninvasive investigation to evaluate the myocardial changes in dynamics, until the remision.

Key words: hypertrophic cardiomyopathy, newborn, echocardiography, diabetic mother

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CARDIOMIOPATIA HIPERTROFICA TRANZITORIE A NOU-NASCUTULUI

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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CARDIOMIOPATIA HIPERTROFICA TRANZITORIE A NOU-NASCUTULUI

REZUMAT

Contracţia şi relaxarea miocardului suferă modificări permanente în timpul vieţii fetale şi pe parcursul trecerii din stadiul de nou-născut la adult. Cordul nou-născutului este imatur din punct de vedere structural şi funcţional faţă de agresiunile la care trebuie să răspundă, fiind organul ţintă al stresului perinatal. Multe modificări sunt atribuite ischemiei perinatale (insuficienţa cardiacă, regurgitarea mitrală sau tricuspidiană, modificări ischemice ale ECG), dar şi hiperinsulinemiei endogene induse la făt de mama diabetică. Ecocardiografia este investigaţia de bază pentru evaluarea modificărilor miocardice în dinamică, până la remiterea lor.

Cuvinte cheie: cardiomiopatie hipertrofică, nou-născut, diabet matern, ecocardiografie

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Child with oncological diseases in intensive care unit

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 4, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Child with oncological diseases in intensive care unit

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ABSTRACT

Recently made advances in oncology have significantly improved the prognosis of children with neoplastic disease. Improvement of survival is accompanied by an increased risk of severe complications which may require intensive care. The aim of this study is the retrospective evaluation of the frequency of comorbidities that led to the transfer of patients from hematology- oncology department to intensive care unit in a period of 3 years. The study group consisted of 54 children (aged 9 month-17 years), representing 1,2 % from all admissions in hemato-oncology department during this period. LAL was the most frequent of hematologic malignancies admitted to intensive care unit (31% of cases). Respiratory failure was the main reason for transfer (23 cases-42,5%), followed by sepsis and shock (17 cases-31,4%). Oxygen (21 cases), electrolyte balancing (9 cases) and administration of inotropic agents like dopamine and / or dobutamine (6 cases) were the main specific treatments performed in intensive care. The mortality rate recorded in this group, in the intensive care unit was 27.7%, being smaller for solid tumors. Early recognition of signs of deterioration and admission to intensive care unit in a timely manner may improve prognosis, but the decision to transfer is delicate, involving the intensivist, the oncologist, the family and the patient, when he is able to.

Key words: neoplasia, intensive care, child

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COPILUL CU AFECTIUNI ONCOLOGICE IN TERAPIA INTENSIVA

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 4, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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COPILUL CU AFECTIUNI ONCOLOGICE IN TERAPIA INTENSIVA

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REZUMAT

Progresele făcute în oncologie în decursul ultimilor ani au ameliorat considerabil prognosticul copiilor cu afecţiuni neoplazice. Ameliorarea supravieţuirii se însoţeşte însă de o creştere a riscului de complicaţii severe pentru care pacientul poate necesita îngrijiri în terapie intensivă. Scopul acestui studiu constă în evaluarea retrospectivă, într-o perioadă de 3 ani, a frecvenţei unor comorbidităţi care au determinat transferul bolnavilor din secţia de hemato-oncologie în cea de terapie intensivă. Lotul de studiu a cuprins 54 de copii (vârsta 9 luni-17 ani) reprezentând 1,2% din totalul inernărilor în hemato-oncologie în intervalul menţionat. Dintre hemopatiile maligne admise în terapie intensivă a predominat LAL (31% din cazuri). Insuficienţa respiratorie a constituit principalul motiv de transfer (23 de cazuri – 42,5%), urmat de sepsis şi şoc (17 cazuri – 31,4%). Principalele tratamente specifice efectuate în terapie intensivă au fost oxigenoterapia (21 de cazuri), reechilibrarea hidroelectrolitică (9 cazuri) şi administrarea de agenţi inotropi tip Dopamină şi / sau Dobutamină (6 cazuri). Mortalitatea înregistrată la acest lot, în secţia de terapie intensivă a fost de 27,7%, fiind mai mică pentru tumorile solide. Recunoaşterea precoce a semnelor de agravare şi internarea în terapie intensivă în timp util pot duce la îmbunătăţirea prognosticului, însă această decizie de transfer este delicată, la ea trebuind să participe medicul de terapie intensivă, hemato-oncologul, familia şi pacientul, când acesta este capabil.

Cuvinte cheie: neoplazie, terapie intensivă, copil

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