Análise dos aspectos éticos da pesquisa em seres humanos contidos nas instruçöes aos autores de 139 revistas científicas brasileiras / Recommendations on ethical aspects included in the instructions to authors: analysis of 139 brazilian scientific journals

Objetivo. Estudar as normas relativas à ética da pesquisa em seres humanos contidas nas instruções aos Autores de revistas científicas brasileiras. Material e Métodos. As Instruções aos Autores de 139 revistas científicas brasileiras das áreas de medicina, biomedicina, enfermagem, odontologia e ciências gerais foram analisadas com relação às suas recomendações sobre os aspectos éticos. Resultados. Das 139 revistas estudadas, 110 (79,1 por cento) não fazem referências aos aspectos éticos; 17 (12,2 por cento) exigem aprovação prévia pela Comissão de Ética; três (2,1 por cento) fazem referência à Declaração de Helsinque; uma (0,7 por cento) recomenda adotar o consentimento esclarecido; cinco (3,5 por cento) seguem orientações dos requisitos uniformes para manuscritos submetidos a revistas biomédicas e três (2,1 por cento) seguem princípios, normas e padrões éticos não especificados. Nas 29 revistas que fazem referências à ética, as exigências são solicitadas sob as seguintes formas: 15 (51,7 por cento) exigem a inclusão da informação no texto do artigo; duas (6,8 por cento) pedem carta assinada pelos autores; uma (3,4 por cento) solicita cópia da autorização da Comissão de Ética; uma (3,4 por cento) afirma supor que o autor cumpriu as exigências e dez (34,4 por cento) não fazem qualquer referência específica. Conclusões. Os resultados do estudo indicam que na maioria das revistas científicas brasileiras há pouca preocupação em relação aos aspectos éticos da pesquisa em seres humanos, contidas nas Instruções aos Autores. Nas revistas que fazem referência aos aspectos éticos, as exigências são muito variáveis.

[Analysis of ethical aspects on human experimentation included in the instructions for the authors in 139 Brazilian scientific journals]. / Análise dos aspectos éticos da pesquisa em seres humanos contidos nas instruções aos autores de 139 revistas científicas brasileiras.

UNLABELLED: The concern with ethical standards during research in human subjects has been improving in Brazil during the last decade. Analysis of the ethical recommendations in instructions to authors may contribute to understand Brazilian Scientific Journals policies. OBJECTIVE: To evaluate the recommendations related to the ethics of investigation in human subjects in instructions to authors of Brazilian Scientific Journals. MATERIAL AND METHODS: Instructions to authors of 139 Brazilian Scientific Journals in medicine, biomedicine, nursery, odontology and general sciences were analysed. RESULTS: In one hundred ten (79.1%) of the 139 journals no recommendations related to ethics were found; 17 (12.2%) required previous approval by the institutional committee; 3 (2.1%) the procedures should be in accordance with the Declaration of Helsinki; 1 (0.7%) recommends the application of the informed consent; 5 (3.5%) recommend the use of Uniform requirements for manuscripts submitted to biomedical journals and 3 (2.1%) follow no specified rules. Twenty nine journals ask for references in ethics standards: in 15 (51.7%) the information must be included in the text; in 2 (6.8%) the authors must send a letter informing how the ethics standards were followed; in 1 (3.4%) a copy of the approval by the institutional committee must be included; in 1 (3.4%) believed the authors followed the standards and in 10 (34.4%) no specific reference was made. CONCLUSION: These results indicated that the majority of Brazilian Scientific Journals have little concern related to ethical aspects of research in human subjects included in instructions to authors. Even journals that make references to the ethical aspects the recommendations are quite different.

[Hospital infection--ethical aspects]. / Infecção hospitalar--aspectos éticos.

The author focuses the question of hospital infection, analysing the background on which the control committees were created. The hospital infection is discussed under bioethical principles and the Medical Ethics Code, examining the aspects related to the government, the Hospital Directorship, the Committee and the Control Service of Hospital Infection, and the assisting physician. A closer integration between the activities of the Program of Control of Hospital Infections and those of the Medical Ethics Committee is proposed, aiming at the patient and at the community, "targets of total medical attention".

Functional and ultrastructural evaluation of myocardial protection provided by intermittent coronary sinus perfusion in the isolated dog heart

The protection offered by intermittent perfusion of cardioplegic solution through the coronary sinus was investigated in isovolumic blood-perfused dog heart preparations submitted to 60 min of ischemia and 45 min of reperfusion. The prepations were divided into three treatment groups: a) coronary sinus, consisting of preparations (N=10) perfused through the coronary sinus under 40 cm water pressure: b) aortic, consisting of preparations (N=10) perfused through the aortic stump under 100 mm Hg pressure; c) control,consisting of hearts (N=9) that were not perfused with cardioplegic solution. Properties of contractile capacity and relaxation were markedly impaired in the control group but were preserved to a comparable extent in the groups perfused with cardioplegic solution through the aorta and coronary sinus. Developed pressure decreased in the control group (before ischemia: 70 ñ 5.5 mmHg; after reperfusion: 35 ñ 12 mmHg; P,0.05) and didn't vary in the aortic group (from 69 ñ 4mmHg to 65 ñ 13 mmHg: P>0.05) and coronary sinus group (from 69 ñ 4.6 mmHg to 60 ñ 10 mmHg; P>0.05). Myocardial relaxation was evaluated by the +/-dp/dt ratio. In the control group there was impairment of myocardial relation as indicated by an increase of this index after reperfusion (from 1.05 ñ 0.05 to 1.46 ñ 0.23; P<0.05), whereas in the aortic (from 1.10 ñ 0.13 to 1.15 ñ 0.20; P>0.05) and the coronary sinus (from 1.03 ñ 0.14 to 1.08 ñ 0.16; P>0.05) groups there was no variation. Ultrastructural changes in the myocardium were negligible in all three groups at the end of reperfusion. We conclude that intermittent perfusion of a hypothermic cardioplegic solution through the coronary sinus is effective for the protection of the myocardium during total ischemia

Functional and ultrastructural evaluation of myocardial protection provided by intermittent coronary sinus perfusion in the isolated dog heart.

1. The protection offered by intermittent perfusion of cardioplegic solution through the coronary sinus was investigated in isovolumic blood-perfused dog heart preparations submitted to 60 min of ischemia and 45 min of reperfusion. 2. The preparations were divided into three treatment groups: a) coronary sinus, consisting of preparations (N = 10) perfused through the coronary sinus under 40 cm water pressure; b) aortic, consisting of preparations (N = 10) perfused through the aortic stump under 100 mmHg pressure; c) control, consisting of hearts (N = 9) that were not perfused with cardioplegic solution. 3. Properties of contractile capacity and relaxation were markedly impaired in the control group but were preserved to a comparable extent in the groups perfused with cardioplegic solution through the aorta and coronary sinus. Developed pressure decreased in the control group (before ischemia: 70 +/- 5.5 mmHg; after reperfusion: 35 +/- 12 mmHg; P less than 0.05) and didn't vary in the aortic group (from 69 +/- 4 mmHg to 65 +/- 13 mmHg; P greater than 0.05) and coronary sinus group (from 69 +/- 4.6 mmHg to 60 +/- 10 mmHg; P greater than 0.05). Myocardial relaxation was evaluated by the +/- dp/dt ratio. In the control group there was impairment of myocardial relaxation as indicated by an increase of this index after reperfusion (from 1.05 +/- 0.05 to 1.46 +/- 0.23; P less than 0.05), whereas in the aortic (from 1.10 +/- 0.13 to 1.15 +/- 0.20; P greater than 0.05) and the coronary sinus (from 1.03 +/- 0.14 to 1.08 +/- 0.16; P greater than 0.05) groups there was no variation. Ultrastructural changes in the myocardium were negligible in all three groups at the end of reperfusion. 4. We conclude that intermittent perfusion of a hypothermic cardioplegic solution through the coronary sinus is effective for the protection of the myocardium during total ischemia.

Effects of dopamine on the pulmonary circulation of the dog.

The effects of dopamine infusion (10 and 20 micrograms kg-1 min-1) on pulmonary arterial pressure (PAP) and pulmonary arterial resistance (PAR) were studied. Experiments were carried out on 60 anesthetized dogs using two different models: model A, with mechanical perfusion of pulmonary circulation and constant left ventricular output, and model B, with physiologic pulmonary perfusion and non-fixed ventricular output. When pulmonary blood flow was constant, dopamine did not change PAP or PAR at either dose. When cardiac output (CO) was allowed to increase, PAP increased with dopamine at both doses, whereas PAR did not change with 20 micrograms kg-1 min-1 dopamine and was reduced by the 10 micrograms kg-1 min-1 dose. We conclude that the increase in PAP could not be explained solely by the rise in CO, but was probably related to an inhibitory effect of dopamine on pulmonary vascular accommodation and to increases in CO, especially when the drug was utilized at higher doses.

Necrose da pequena curvatura gastrica apos vagotomia gastrica proximal por traumatismo da parede gastrica. Estudo experimental em caes. / Necrosis of lesser gastric curvature after proximal gastric vagotomy by traumatic lesion of the gastric wall. Experimental study in dogs

Com o objetivo de estudar a necrose isquemica da pequena curvatura gastrica, apos vagotomia gastrica proximal (VGP), foram operados 36 caes distribuidos por sorteio em dois grupos experimentais: Grupo 1 VGP e Grupo 2 - VGP e traumatismo da parede gastrica. Este tipo de traumatismo foi realizado atraves de uma ligadura, englobando a parede gastrica, com fio de algodao no. 10. Pelos resultados obtidos verificamos que a desvascularizacao determinada pelas ligaduras dos pediculos vasculonervosos, na tecnica de VGP, conserva a irrigacao necessaria a nutricao e manutencao dos tecidos da pequena curvatura gastrica. As ligaduras englobando a parede gastrica podem determinar desde necrose parcial ou total, com perfuracao e peritonite, ate lesoes semelhantes a ulcera cronica. Nos casos de necrose parcial da parede gastrica podem ocorrer tambem lesoes da mucosa gastrica tais como: exulceracao, sufusao hemorragica e convergencia de pregas da mucosa para o local de traumatismo

[Acute hepatic insufficiency in guinea pigs. Experimental model caused by the injection of monoethanolamine oleate]. / Insuficiência hepática aguda no cobaio. Modelo experimental causado pela injecão de oleato de monoetanolamina.

An appropriate animal model of acute fulminant hepatic failure was developed in the guinea pig by he intrabiliary administration of monoethanolamine oleate. The animals were assigned in two experimental groups: 1) ethanolamine group - 42 guinea pigs that received intrabiliary 2,5 ml injection of monoethanolamine oleate; 2) control group - 18 guinea pigs subjected to intrabiliary 2,5 ml administration of saline. The intrabiliary administration of the ethanolamine oleate resulted in massive liver injury with 85,9% of hepatic coma during the first 96 hr. The liver damage was characterized by clinical manifestations (anorexia, increasing stupor, muscle wasting and deep coma), serum biochemical tests (elevations of serum transaminases, bilirubins , alkaline phosphatase), studies of blood coagulation (prothrombin and partial thromboplastin times were markedly prolonged and the concentration of fibrinogen decreased) and histopathological findings (massive hepatic necrosis). This animal model appears promising for future studies of the pathogenesis and treatment of acute hepatic failure.

Insuficiencia hepatica aguda no cobaio. Modelo experimental causado pela injecao de oleato de monoetanolamina. / Acute hepatic insufficiency in guinea pigs. Experimental model caused by monoethanolamina oleate injection

Com o objetivo de produzir um modelo experimental de insuficiencia hepatica aguda (IHA) no cobaio, foram empregados 60 cobaios distribuidos nos seguintes grupos experimentais: a) Grupo Etanolamina - 42 animais submetidos a injecao de 2,5 ml de oleato de monoetanolamina no ducto biliar comun; b) Grupo Controle - 18 animais, nos quais foram injetados 2,5 ml de solucao de NaCI a 0,9% no ducto biliar comum. Foram utilizados para a caracterizacao da IHA os seguintes parametros: quadro clinico, exames laboratoriais (bioquimicos, hematologicos e teste de coagulacao sanguinea) e exame anatomopatologico. A injecao de etanolamina produziu um modelo de insuficiencia hepatica aguda, com a ocorrencia de coma hepatico bem definido em 85,5% dos cobaios nas primeiras 96 horas de evolucao A IHA foi caracterizada pelo quadro clinico tipico de falencia hepatica, alteracoes dos exames bioquimicos (elevacao das bilirrubinas, transaminases e fosfatase alcalina), pelos disturbios da coagulacao sanguinea (alongamento dos tempos de protrombina e tromboplastina parcial ativada e queda do fibrinogenio plasmatico) e pela necrose hepatica macica constatada no exame anatomopatolofico.O modelo experimental desenvolvido pode ser util para o estudo da fisiopatologia da insuficiencia hepatica e para a pesquisa de novos metodos terapeuticos do coma hepatico

Um novo modelo experimental de insuficiencia hepatica aguda. / A new experimental model of acute hepatic insufficiency

E apresentado um novo modelo de insuficiencia hepatica aguda no cobaio, produzido pela injecao intrabiliar de solucao esclerosante. Foram empregados 100 cobaios distribuidos em dois grupos experimentais: 1) Grupo Solucao Esclerosante - 70 animais submetidos a injecao no ducto biliar comum de uma solucao constituida por fenol, acido acetico glacial, glicerina e agua bidestilada na dose de 1 ml. 2) Grupo Controle - 30 animais, noa quais foram injetados 1 ml de solucao de NaCl a 0,9%.A injecao da solucao esclerosante no ducto biliar produziu em 52,9% dos cobaios insuficiencia hepatica aguda caracterizada por: a) quadro clinico bem definido, com evolucao para o coma hepatico de instalacao lenta e longa duracao: b) alteracao dos exames bioquimicos e dos testes de coagulacao sanguinea; c) alteracoes anatomo-patologicas. O modelo experimental desenvolvido pode ser util para o estudo dos mecanismos fisiopatologicos envolvidos na insuficiencia hepatocelular e para a avaliacao de novos metodos para o tratamento do coma hepatico