RESUMO
Etanercept is a tumor necrosis factor alpha (TNF-α) inhibitor chronically used to treat autoimmune diseases. However, the use of etanercept during pregnancy still needs to be further investigated. The aim of this study is to evaluate the etanercept treatment during pregnancy, analyzing maternal reproductive performance, fetal outcomes, and placental repercussions. Wistar rats (200-250 g) were mated and randomly distributed into two experimental groups: control and etanercept (n = 10 animals/group). Treatments with etanercept (0.8 mg/kg, s.c.), or saline (control group) were carried out on days 0, 6, 12, and 18 of gestation. On the morning of the 21st day of pregnancy, rats were euthanized in a CO2 chamber and submitted to laparotomy to remove the fetuses, placentas, ovaries, and maternal organs. There were no differences between groups in the following parameters: water and food consumption; placental efficiency; reproductive parameters, including number of corpora lutea and implants, reabsorption, and pre- and post-implantation losses. However, etanercept treatment increased liver weight, reduced fetal and placental weight, decreased the placental junction zone, reduced the percentage of normal fetuses, and increased visceral or skeletal fetal abnormalities. Therefore, etanercept resulted in damages more related to fetus and placenta. However, more studies with different doses are required to better predict possible injuries elicited using etanercept during pregnancy.
RESUMO
Estudo descritivo, exploratório, com abordagem qualitativa. Buscou-se conhecer as experiências da equipe de enfermagem, com a morte de uma criança indígena hospitalizada e os sentimentos que emergiram dessa vivência. Participaram da pesquisa 11 profissionais. A coleta de dados foi realizada na Unidade Pediátrica de um hospital público municipal do interior do Estado de Mato Grosso. Após análise, as entrevistas foram agrupadas nos seguintes eixos temáticos: sentimentos manifestados pelo cuidador; estratégias de enfrentamento da morte; acolhimento à família perante a morte; o vivenciar da morte indígena versus não indígena; vivências com a negligência e o preconceito; impacto da morte na vida e saúde do profissional; impacto na vida do profissional; e apoio psicológico ao profissional. A equipe de enfermagem sofre frente à morte da criança indígena, o que acaba influenciando sua vida e suas atitudes, tanto no ambiente hospitalar como fora dele.
Descriptive, exploratory study, using a qualitative approach. The aim of this study was to learn the experiences of the nursing team in face of the death of a hospitalized indigenous child and the feelings that emerged from this experience. Participants were 11 professionals. Data were collected in the pediatric unit of a municipal public hospital in the interior of Mato Grosso state, Brazil. After analysis, the interviews were grouped into the following themes: feelings expressed by the caregiver; strategies for coping with death; support to the family in face of death; the experience of an indigenous versus a non-indigenous death; experiences with prejudice and negligence; the impact of death on the life and health of the professional; impact on the life of the professional; and psychological support to the professional. The nursing team suffers in face of the death of an indigenous child, which influences their lives and attitudes both in and outside the hospital environment.
Un enfoque cualitativo descriptivo, exploratorio. Tuvo como objetivo investigar la experiencia del personal de enfermería con la muerte de niños indígenas hospitalizados y los sentimientos que surgieron de esta experiencia. Participaron en la encuesta 11 profesionales. La recolección de datos se llevó a cabo en la Unidad Pediátrica de un hospital público municipal en el estado de Mato Grosso, Brasil. Tras el análisis, las entrevistas fueron agrupados en los siguientes temas: los sentimientos expresados por el cuidador; estrategias de afrontamiento; el apoyo a la muerte de la familia antes de la muerte; la experiencia de la muerte indígenas versus no indígenas; experiencias de abandono y perjuicio; el impacto de la muerte, de la vida y de la salud profesional; impacto en la vida de los profesionales; y el apoyo psicológico profesional. El personal de enfermería sufre antes de la muerte del niño indígena que influye en sus vidas y actitudes tanto dentro como fuera del entorno hospitalario.