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Magdalena Iorga

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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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ASPECTE ETICE IN FIBROZA CHISTICA

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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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ASPECTE ETICE IN FIBROZA CHISTICA

and

REZUMAT

În ultimele decade, progresele rapide în diagnosticul şi tratamentul fibrozei chistice au condus la apariţia unor probleme etice legate de screeningul neonatal, terapia genică, transplantul de organe şi fertilitate. De asemenea, tranziţia bolnavilor cu fibroză chistică de la copil la adult este nu numai o problemă profesională, ci şi de etică. Înţelegerea aspectelor etice din această afecţiune este crucială pentru furnizarea îngrijirilor optime.

Cuvinte cheie: fibroză chistică, etică, screening, terapie genică, transplant, fertilitate

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ETYHICAL ISSUES IN CYSTIC FIBROSIS

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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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ETYHICAL ISSUES IN CYSTIC FIBROSIS

and

ABSTRACT

In recent decades, the rapid advances in the diagnosis and treatment of cystic fibrosis led to the emergence of ethical issues related to neonatal screening, gene therapy, organ transplantation, and fertility. Also, transition of patients with cystic fibrosis from pediatric to adult care is not only a professional but also an ethical issue. Understanding the ethical issues related to this condition is crucial to providing optimal care.

Keywords: cystic fibrosis, ethical, screening, gene therapy, transplants, fertility

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RECOMANDARI PRE-PROCEDURALE IN ENDOSCOPIA DIGESTIVA LA PACIENTUL PEDIATRIC

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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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RECOMANDARI PRE-PROCEDURALE IN ENDOSCOPIA DIGESTIVA LA PACIENTUL PEDIATRIC

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REZUMAT

Endoscopia digestivă, una dintre cele mai frecvente investigaţii invazive în gastroenterologia pediatrică, nu este lipsită de riscuri. Complexul de măsuri necesare acestei manevre cuprinde: evaluarea corectă a bolnavului ţinând seama de indicaţiile şi contraindicaţiile endoscopiei, obţinerea consimţământului informat, pregătirea psihologică a părinţilor/copilului, aplicarea unor restricţii dietetice, profilaxia infecţiilor. De asemenea, trebuie ales tipul de anestezie, monitorizarea continuă intra şi post-procedurală pentru evitarea complicaţiilor legate de procedură sau de reacţii adverse medicamentoase.

Cuvinte cheie: anestezie, endoscopie digestivă, copil

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PRE-PROCEDURAL RECOMMENDATIONS IN PEDIATRIC GASTROINTESTINAL ENDOSCOPY

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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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PRE-PROCEDURAL RECOMMENDATIONS IN PEDIATRIC GASTROINTESTINAL ENDOSCOPY

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ABSTRACT

Gastrointestinal endoscopy is one of the most common invasive procedures carried out in pediatric gastroenterology and is not without risk. The range of necessary measures for the purpose of this procedure includes: the accurate assessment of the patient considering the endoscopy-related indications and contraindications, obtaining the informed consent, the psychological preparation of the parents/child, applying some dietary restrictions, and infection prophylaxis. It is also necessary to choose the type of sedation and ensure the constant monitoring during and after the procedure so as to avoid any complications related to the procedure or to the side effects of drugs.

Keywords: procedural sedation, gastrointestinal endoscopy, child

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ETICA PRESCRIERII OFF-LABEL A MEDICAMENTELOR LA COPII. DILEMA SILDENAFILULUI

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ETICA PRESCRIERII OFF-LABEL A MEDICAMENTELOR LA COPII. DILEMA SILDENAFILULUI

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REZUMAT

Prescripţia „off-label“ reprezintă administrarea medicamentelor pe o cale neaprobată, într-o formulare sau doză neaprobată la copii, sau sub intervalul de vârstă indicat pe prospectul aprobat al produsului. Cu toate acestea, tratamentul cu indicaţii off-label este un fenomen larg răspândit în clinicile de pediatrie. Deoarece multe dintre medicamentele prescrise nu au fost testate în mod adecvat la copii, această populaţie de pacienţi rămâne vulnerabilă. Pe de o parte, folosirea indicaţiilor off-label la copii determină o mulţime de controverse, pe de altă parte, fără această posibilitate, unii pacienţi ar putea fi lipsiţi de şansa de a fi trataţi. Lucrarea prezintă amplitudinea fenomenului de prescriere a medicamentelor cu indicaţii off-label la copii, evaluată în studii ştiinţifice din SUA şi Europa. În multitudinea de medicamente prescrise off-label la copii se înscrie şi Sildenafil. Autorii îşi propun prezentarea situaţiei din România cu privire la medicamentul Sildenafil şi utilizarea acestuia în unităţile de cardiologie pediatrică.

Cuvinte cheie: etica, medicamente, copii, prescriere, off-label

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THE ETHICS OF PRESCRIBING OFF-LABEL DRUGS IN CHILDREN. THE DILEMMA OF SILDENAFIL

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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THE ETHICS OF PRESCRIBING OFF-LABEL DRUGS IN CHILDREN. THE DILEMMA OF SILDENAFIL

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ABSTRACT

The off-label prescription means that medicines are administered by an unlicensed route, in an unlicensed formulation or dosage or to a child below the stated age range. The use of drugs in an off-label or unlicensed manner to treat children is widespread. Because many prescribed treatments for children have not been adequately tested in children, this population of patients remains a vulnerable one. On the one hand, prescribing off-label use drugs in children determines a lot of controversies but, one the other hand, without this possibility, could be deprived of a chance to be treated. The paper presents the widespread phenomenon of off-label us drugs in children, reflecting in scientific studies in USA and Europe. An important focus is on Romanian statistic of Sildenafil prescription and on dilemmatic use of it in pediatric cardiology unit.

Keywords: ethics, drugs, children, prescribing, off-label

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